| New Covenant Pediatric Center, Pllc | |
|
Rr 2 Box 375g Lewisburg WV 24901-9346 | |
| (304) 645-8009 | |
| (304) 645-8011 |
| Full Name | New Covenant Pediatric Center, Pllc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | Rr 2 Box 375g, Lewisburg, West Virginia |
| Authorized Official Name and Position | Timothy J York (OWNER) |
| Authorized Official Contact | 3046458009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| New Covenant Pediatric Center, Pllc 360 Washington Street, West Lewisburg WV 24901 Ph: (304) 645-8009 | New Covenant Pediatric Center, Pllc Rr 2 Box 375g Lewisburg WV 24901-9346 Ph: (304) 645-8009 |
| NPI Number | 1417071812 |
|---|---|
| Provider Enumeration Date | 03/19/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417071812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 1878 (West Virginia) | Primary |
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