| Braxton County Memorial Hospital | |
|
617 River St Gassaway WV 26624-1137 | |
| (304) 364-2401 | |
| Not Available |
| Full Name | Braxton County Memorial Hospital |
|---|---|
| Speciality | Clinic/Center |
| Location | 617 River St, Gassaway, West Virginia |
| Authorized Official Name and Position | Kimberly D Knight (CFO) |
| Authorized Official Contact | 3043641128 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Braxton County Memorial Hospital 100 Hoylman Dr Gassaway WV 26624-9321 Ph: (304) 364-1093 | Braxton County Memorial Hospital 617 River St Gassaway WV 26624-1137 Ph: (304) 364-2401 |
| NPI Number | 1639278518 |
|---|---|
| Provider Enumeration Date | 09/21/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 5193717759 |
|---|---|
| Medicare Enrollment ID | O20080611000716 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639278518 | NPI | - | NPPES |
| 5360015000 | Medicaid | WV | |
| BR5113081 | Other | WV | MEDICARE PART B GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 002 (West Virginia) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | 031428 (West Virginia) | Primary |
Community Care Of West Virginia, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 113 5th St, Gassaway, WV 26624 Phone: 304-364-5291 Fax: 304-364-8547 | |
Braxton Health Associates, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 617 River St, Gassaway, WV 26624 Phone: 304-364-8941 Fax: 304-364-8943 |