| Southern West Virginia Health System-whitesville | |
|
37456 Coal River Rd Whitesville WV 25209-9077 | |
| (304) 854-1321 | |
| Not Available |
| Full Name | Southern West Virginia Health System-whitesville |
|---|---|
| Speciality | Clinic/Center |
| Location | 37456 Coal River Rd, Whitesville, West Virginia |
| Authorized Official Name and Position | Lisa Leach (CEO) |
| Authorized Official Contact | 3048245806 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern West Virginia Health System-whitesville 7400 Lynn Ave Hamlin WV 25523-1138 Ph: (304) 824-5806 | Southern West Virginia Health System-whitesville 37456 Coal River Rd Whitesville WV 25209-9077 Ph: (304) 854-1321 |
| NPI Number | 1528768322 |
|---|---|
| Provider Enumeration Date | 03/09/2023 |
| Last Update Date | 03/16/2023 |
| Medicare PECOS PAC ID | 6204821879 |
|---|---|
| Medicare Enrollment ID | O20230615003667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528768322 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Raleigh Boone Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 37456 Coal River Rd, Whitesville, WV 25209 Phone: 304-845-1323 Fax: 304-854-1031 |