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325 E. Main Street Wardensville WV 26851 | |
(304) 874-4012 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 325 E. Main Street, Wardensville, West Virginia |
Authorized Official Name and Position | Meredith Michelle Heishman (CREDENTIALING) |
Authorized Official Contact | 3048975915 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 97 Baker WV 26801-0097 Ph: (304) 897-5915 | 325 E. Main Street Wardensville WV 26851 Ph: (304) 874-4012 |
NPI Number | 1669074175 |
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Provider Enumeration Date | 11/10/2020 |
Last Update Date | 12/29/2020 |
Medicare PECOS PAC ID | 6204728041 |
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Medicare Enrollment ID | O20201211002021 |
Identifier | Type | State | Issuer |
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1669074175 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |