| Healthcare 360 Pllc | |
|
9016 Seneca Trail Ronceverte WV 24970-8375 | |
| (681) 318-3477 | |
| (681) 318-3479 |
| Full Name | Healthcare 360 Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 9016 Seneca Trail, Ronceverte, West Virginia |
| Authorized Official Name and Position | Jane Leigh Bryant (MANAGER) |
| Authorized Official Contact | 6813183477 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthcare 360 Pllc 9016 Seneca Trail Ronceverte WV 24970-8375 Ph: (681) 318-3477 | Healthcare 360 Pllc 9016 Seneca Trail Ronceverte WV 24970-8375 Ph: (681) 318-3477 |
| NPI Number | 1437780269 |
|---|---|
| Provider Enumeration Date | 01/30/2020 |
| Last Update Date | 11/22/2021 |
| Medicare PECOS PAC ID | 7113357757 |
|---|---|
| Medicare Enrollment ID | O20200422000231 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437780269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael S Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902895584 PECOS PAC ID: 2668426586 Enrollment ID: I20061229000160 |
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