| Jefferson School Based Health And Wellness Center | |
|
1200 Stephenson Ave Parkersburg WV 26101-4889 | |
| (304) 699-0506 | |
| Not Available |
| Full Name | Jefferson School Based Health And Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1200 Stephenson Ave, Parkersburg, West Virginia |
| Authorized Official Name and Position | Amy Yokum (CEO) |
| Authorized Official Contact | 3046434005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson School Based Health And Wellness Center L-4162 Columbus OH 43260-0001 Ph: (304) 643-4005 | Jefferson School Based Health And Wellness Center 1200 Stephenson Ave Parkersburg WV 26101-4889 Ph: (304) 699-0506 |
| NPI Number | 1700900818 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 05/09/2023 |
| Medicare PECOS PAC ID | 0244142453 |
|---|---|
| Medicare Enrollment ID | O20101103001210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700900818 | NPI | - | NPPES |
| 3810008181 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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