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137 8th Ave W Huntington WV 25701-2510 | |
| (681) 888-5291 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 137 8th Ave W, Huntington, West Virginia |
| Authorized Official Name and Position | Cory Lilly (UTILIZATION MANAGER) |
| Authorized Official Contact | 3044083256 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
137 8th Ave W Huntington WV 25701-2510 Ph: (681) 888-5291 | 137 8th Ave W Huntington WV 25701-2510 Ph: (681) 888-5291 |
| NPI Number | 1760037014 |
|---|---|
| Provider Enumeration Date | 08/05/2019 |
| Last Update Date | 05/05/2023 |
| Certification Date | 05/05/2023 |
| Medicare PECOS PAC ID | 7719387364 |
|---|---|
| Medicare Enrollment ID | O20210618000141 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760037014 | NPI | - | NPPES |
| Provider Name | Mary Rogers Aldred-crouch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326198094 PECOS PAC ID: 6305943598 Enrollment ID: I20070523000249 |
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