| Greenbrier Care Llc | |
|
167 Kates Mountain Road White Sulphur Springs WV 24986-2414 | |
| (304) 536-4870 | |
| (304) 536-8010 |
| Full Name | Greenbrier Care Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 167 Kates Mountain Road, White Sulphur Springs, West Virginia |
| Authorized Official Name and Position | Richard B Kline (PHYSICIAN) |
| Authorized Official Contact | 3045364870 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenbrier Care Llc 167 Kates Mountain Road White Sulphur Springs WV 24986-2414 Ph: (304) 536-4870 | Greenbrier Care Llc 167 Kates Mountain Road White Sulphur Springs WV 24986-2414 Ph: (304) 536-4870 |
| NPI Number | 1629266432 |
|---|---|
| Provider Enumeration Date | 10/05/2007 |
| Last Update Date | 09/24/2013 |
| Medicare PECOS PAC ID | 3678650470 |
|---|---|
| Medicare Enrollment ID | O20080403000254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629266432 | NPI | - | NPPES |
| DG9945 | Other | WV | RAILROAD PTAN |
| 345877 | Other | VA | ANTHEM |
| 02007626 | Other | WV | BLUECROSS/BLUESHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 11804 (West Virginia) | Primary |
| Provider Name | Belinda K Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487659561 PECOS PAC ID: 9830100783 Enrollment ID: I20060508000336 |
| Provider Name | Thomas Owen Dotson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124069141 PECOS PAC ID: 8123163979 Enrollment ID: I20100303001126 |
| Provider Name | Martye Lois Marshall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841253648 PECOS PAC ID: 6800843657 Enrollment ID: I20120925000569 |
| Provider Name | Randolph E Modlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942259114 PECOS PAC ID: 4486873395 Enrollment ID: I20140908001951 |
| Provider Name | Tamra Stall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023192994 PECOS PAC ID: 0941341440 Enrollment ID: I20141213000000 |
| Provider Name | Kelly K Redden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972787109 PECOS PAC ID: 5395876171 Enrollment ID: I20160111002388 |
| Provider Name | Sherri L Gwinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801247978 PECOS PAC ID: 5597044743 Enrollment ID: I20161111000453 |
Rainelle Medical Center, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 128 Community Ln, White Sulphur Springs, WV 24986 Phone: 304-438-6188 Fax: 304-438-4037 | |
Wvva Health Care Alliance Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 Pocahontas Trl, White Sulphur Springs, WV 24986 Phone: 304-536-5030 Fax: 304-536-5051 |