| Valley Health Wayne High School | |
|
100 Pioneer Rd Wayne WV 25570 | |
| (304) 272-3783 | |
| Not Available |
| Full Name | Valley Health Wayne High School |
|---|---|
| Speciality | Clinic/Center |
| Location | 100 Pioneer Rd, Wayne, West Virginia |
| Authorized Official Name and Position | Mary-beth Brubeck (VICE PRESIDENT OF FINANCE / CFO) |
| Authorized Official Contact | 3045253334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley Health Wayne High School Po Box 1680 Huntington WV 25717-1680 Ph: () - | Valley Health Wayne High School 100 Pioneer Rd Wayne WV 25570 Ph: (304) 272-3783 |
| NPI Number | 1194790022 |
|---|---|
| Provider Enumeration Date | 02/22/2006 |
| Last Update Date | 03/31/2022 |
| Medicare PECOS PAC ID | 9931017969 |
|---|---|
| Medicare Enrollment ID | O20121112000395 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194790022 | NPI | - | NPPES |
| 5369023000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 11577 (West Virginia) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (West Virginia) | Primary |
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