| Southern West Virginia Health System-madison Medical | |
|
471 Main St Madison WV 25130-1223 | |
| (304) 369-5170 | |
| (304) 306-7982 |
| Full Name | Southern West Virginia Health System-madison Medical |
|---|---|
| Speciality | Clinic/Center |
| Location | 471 Main St, Madison, West Virginia |
| Authorized Official Name and Position | Letitia Ann Weaver (CREDENTIALING COORDINATOR) |
| 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-madison Medical 7400 Lynn Ave Hamlin WV 25523-1138 Ph: (304) 824-5806 | Southern West Virginia Health System-madison Medical 471 Main St Madison WV 25130-1223 Ph: (304) 369-5170 |
| NPI Number | 1720586472 |
|---|---|
| Provider Enumeration Date | 01/29/2018 |
| Last Update Date | 03/08/2023 |
| Medicare PECOS PAC ID | 6204821879 |
|---|---|
| Medicare Enrollment ID | O20180313002520 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720586472 | NPI | - | NPPES |
| 1720586472 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Boone Memorial Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 701 Madison Ave, Madison, WV 25130 Phone: 304-369-1230 Fax: 304-369-6036 | |
Ernesto T.yutiamco,m.d.,p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 483 Main St, Madison, WV 25130 Phone: 304-369-0221 Fax: 304-369-0222 | |
Bmh Family Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 697 Madison Avenue, Madison, WV 25130 Phone: 304-369-1230 Fax: 304-369-6036 | |
Boone Primary Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 340 State St, Madison, WV 25130 Phone: 304-307-6618 Fax: 304-307-6619 | |
Madison Medical, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 467 Main St, Suite 200, Madison, WV 25130 Phone: 304-369-5170 Fax: 304-369-0946 | |
Women Care Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 404 Riverside Dr W Rm 308309, Madison, WV 25130 Phone: 304-369-4464 |