| Amaris Medical, Llc | |
|
1810 Harper Rd Beckley WV 25801-3331 | |
| (681) 207-7007 | |
| (681) 207-7073 |
| Full Name | Amaris Medical, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1810 Harper Rd, Beckley, West Virginia |
| Authorized Official Name and Position | Angel L Stover (OWNER) |
| Authorized Official Contact | 6812077007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amaris Medical, Llc 1810 Harper Rd Beckley WV 25801-3331 Ph: (681) 207-7007 | Amaris Medical, Llc 1810 Harper Rd Beckley WV 25801-3331 Ph: (681) 207-7007 |
| NPI Number | 1013524057 |
|---|---|
| Provider Enumeration Date | 09/24/2020 |
| Last Update Date | 10/10/2023 |
| Certification Date | 04/27/2023 |
| Medicare PECOS PAC ID | 3072905249 |
|---|---|
| Medicare Enrollment ID | O20220120000515 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013524057 | NPI | - | NPPES |
| 499198 | Other | WV | WV SECRETARY OF STATE |
| Provider Name | Angel L Stover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598992943 PECOS PAC ID: 7719169531 Enrollment ID: I20110315000384 |
| Provider Name | Brandy Cook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184185977 PECOS PAC ID: 1355683772 Enrollment ID: I20190503000500 |
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