Tygart Valley Total Care Clinic | |
500 Market St Grafton WV 26354-1184 | |
(304) 265-0400 | |
(304) 265-6417 |
Full Name | Tygart Valley Total Care Clinic |
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Speciality | Clinic/Center |
Location | 500 Market St, Grafton, West Virginia |
Authorized Official Name and Position | Jeffrey E Lilley (ADMINISTRATOR) |
Authorized Official Contact | 3042650400 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Tygart Valley Total Care Clinic 500 Market St Grafton WV 26354-1184 Ph: (304) 265-0400 | Tygart Valley Total Care Clinic 500 Market St Grafton WV 26354-1184 Ph: (304) 265-0400 |
NPI Number | 1336200344 |
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Provider Enumeration Date | 12/13/2006 |
Last Update Date | 08/23/2010 |
Medicare PECOS PAC ID | 7719897263 |
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Medicare Enrollment ID | O20101022000607 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336200344 | NPI | - | NPPES |
0034632000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 14 (West Virginia) | Primary |
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