| Mustang Health Center | |
|
267 Midway Rd Alum Creek WV 25003-9591 | |
| (304) 756-1007 | |
| (304) 756-1010 |
| Full Name | Mustang Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 267 Midway Rd, Alum Creek, 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 |
|---|---|
| Mustang Health Center 7400 Lynn Ave Hamlin WV 25523-1138 Ph: (304) 824-5806 | Mustang Health Center 267 Midway Rd Alum Creek WV 25003-9591 Ph: (304) 756-1007 |
| NPI Number | 1003274580 |
|---|---|
| Provider Enumeration Date | 01/29/2016 |
| Last Update Date | 10/02/2018 |
| Medicare PECOS PAC ID | 6204821879 |
|---|---|
| Medicare Enrollment ID | O20160714002531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003274580 | NPI | - | NPPES |
| 1003274580 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 2317-5033 (West Virginia) | Primary |
Alum Creek Medical Center, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2150 Childress Road, Alum Creek, WV 25003 Phone: 304-756-9001 Fax: 304-756-2081 |