| Eventus Premier Healthcare - West Virginia Llc | |
|
128 Capitol St Charleston WV 25301-2610 | |
| (855) 743-2247 | |
| Not Available |
| Full Name | Eventus Premier Healthcare - West Virginia Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 128 Capitol St, Charleston, West Virginia |
| Authorized Official Name and Position | Bradley Goad (OWNER) |
| Authorized Official Contact | 8557432247 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eventus Premier Healthcare - West Virginia Llc 101 Cabarrus Ave E Ste 200 Concord NC 28025-3781 Ph: (855) 743-2247 | Eventus Premier Healthcare - West Virginia Llc 128 Capitol St Charleston WV 25301-2610 Ph: (855) 743-2247 |
| NPI Number | 1497576417 |
|---|---|
| Provider Enumeration Date | 10/22/2024 |
| Last Update Date | 11/25/2024 |
| Medicare PECOS PAC ID | 7719417815 |
|---|---|
| Medicare Enrollment ID | O20250204003455 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497576417 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jessica S Terry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780941831 PECOS PAC ID: 2365604790 Enrollment ID: I20120502000009 |
| Provider Name | Megan Abbott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063889749 PECOS PAC ID: 0446550974 Enrollment ID: I20230905003992 |
| Provider Name | Michael Saval |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407483894 PECOS PAC ID: 6204748866 Enrollment ID: I20240430000206 |
| Provider Name | Bradley J Goad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285617241 PECOS PAC ID: 1456244391 Enrollment ID: I20240923000320 |
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