| Burnsville Medical Center Pllc | |
|
110 Municipal Street Burnsville WV 26335-0424 | |
| (304) 853-2278 | |
| (304) 853-2520 |
| Full Name | Burnsville Medical Center Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 110 Municipal Street, Burnsville, West Virginia |
| Authorized Official Name and Position | Antoine Katiny (OWNER) |
| Authorized Official Contact | 3048532278 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Burnsville Medical Center Pllc 110 Municipal Street Po Box 424 Burnsville WV 26335-0424 Ph: (304) 853-2278 | Burnsville Medical Center Pllc 110 Municipal Street Burnsville WV 26335-0424 Ph: (304) 853-2278 |
| NPI Number | 1619090743 |
|---|---|
| Provider Enumeration Date | 04/06/2007 |
| Last Update Date | 10/05/2010 |
| Medicare PECOS PAC ID | 8022104900 |
|---|---|
| Medicare Enrollment ID | O20071024000100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619090743 | NPI | - | NPPES |
| 0034771000 | Medicaid | WV | |
| 0075944000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 17332 (West Virginia) | Primary |
| Provider Name | Antoine Katiny |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407816416 PECOS PAC ID: 2062508948 Enrollment ID: I20071024000057 |
Community Care Of West Virginia, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 228 Kanawha Avenue, Burnsville, WV 26335 Phone: 304-924-6262 Fax: 304-924-5460 |