| Greenbrier Vmc LLC | |
|
Rr 2 Box 171-c Greyrock Professional Park Lewisburg WV 24901-9318 | |
| (304) 793-2059 | |
| Not Available |
| Full Name | Greenbrier Vmc LLC |
|---|---|
| Speciality | Surgery |
| Location | Rr 2 Box 171-c, Lewisburg, West Virginia |
| Authorized Official Name and Position | Debbie Brewer (DIRECTOR OF PROVIDER ENROLLMENT) |
| Authorized Official Contact | 8778929813 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Greenbrier Vmc LLC Po Box 533 Ronceverte WV 24970-0533 Ph: (304) 793-2059 | Greenbrier Vmc LLC Rr 2 Box 171-c Greyrock Professional Park Lewisburg WV 24901-9318 Ph: (304) 793-2059 |
| NPI Number | 1417153172 |
|---|---|
| Provider Enumeration Date | 06/21/2007 |
| Last Update Date | 12/06/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417153172 | NPI | - | NPPES |
| 0106041003 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | () | Secondary |
| 208600000X | Surgery | () | Primary |
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