| Renal Rd Wv Llc | |
|
1811 Coffman St, Barboursville, WV 25504-2023 | |
| (304) 617-4067 | |
| Not Available |
| Full Name | Renal Rd Wv Llc |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 1811 Coffman St, Barboursville, West Virginia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881276665 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
| Provider Name | Jillian Pate |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1245825223 PECOS PAC ID: 2062821747 Enrollment ID: I20210510001829 |
| Mailing Address | Practice Location Address |
|---|---|
| Renal Rd Wv Llc 1811 Coffman St, Barboursville, WV 25504-2023 Ph: (304) 617-4067 | Renal Rd Wv Llc 1811 Coffman St, Barboursville, WV 25504-2023 Ph: (304) 617-4067 |
Jillian Pate, MS, RD, CSR, LD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 1811 Coffman St, Barboursville, WV 25504 Phone: 304-617-4067 | |
Pamela Michelle Harris, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 3 Steiner Blvd, Barboursville, WV 25504 Phone: 304-617-1769 | |
Brittany Paitsel, MS, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1811 Coffman St, Barboursville, WV 25504 Phone: 228-276-8170 |