| Logan Regional Primary Care - Holden | |
|
1690 Holden Rd Logan WV 25601-7026 | |
| (304) 239-2147 | |
| (304) 239-2309 |
| Full Name | Logan Regional Primary Care - Holden |
|---|---|
| Speciality | Clinic/Center |
| Location | 1690 Holden Rd, Logan, West Virginia |
| Authorized Official Name and Position | Kathy J. Teague (ASSISTANT VP AND SECRETARY) |
| Authorized Official Contact | 6159207646 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Logan Regional Primary Care - Holden 1690 Holden Rd Logan WV 25601-7026 Ph: (304) 239-2147 | Logan Regional Primary Care - Holden 1690 Holden Rd Logan WV 25601-7026 Ph: (304) 239-2147 |
| NPI Number | 1255064531 |
|---|---|
| Provider Enumeration Date | 07/05/2022 |
| Last Update Date | 07/28/2022 |
| Medicare PECOS PAC ID | 9537078977 |
|---|---|
| Medicare Enrollment ID | O20220903000370 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255064531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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