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12803 Winfield Rd Winfield WV 25213-7452 | |
(304) 757-6999 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 12803 Winfield Rd, Winfield, West Virginia |
Authorized Official Name and Position | Craig Glover (PRESIDENT/CEO) |
Authorized Official Contact | 3047606316 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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97 Great Teays Blvd Ste 6 Scott Depot WV 25560-9816 Ph: (304) 757-6999 | 12803 Winfield Rd Winfield WV 25213-7452 Ph: (304) 757-6999 |
NPI Number | 1760268643 |
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Provider Enumeration Date | 09/06/2023 |
Last Update Date | 02/13/2024 |
Medicare PECOS PAC ID | 4587568134 |
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Medicare Enrollment ID | O20240408000200 |
Identifier | Type | State | Issuer |
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1760268643 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |