| Tygart Valley Total Care Clinic | |
|
500 Market St Grafton WV 26354-1184 | |
| (304) 265-0400 | |
| (304) 265-6417 |
| Full Name | Tygart Valley Total Care Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 500 Market St, Grafton, West Virginia |
| Authorized Official Name and Position | Jeffrey E Lilley (ADMINISTRATOR) |
| Authorized Official Contact | 3042650400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tygart Valley Total Care Clinic 500 Market St Grafton WV 26354-1184 Ph: (304) 265-0400 | Tygart Valley Total Care Clinic 500 Market St Grafton WV 26354-1184 Ph: (304) 265-0400 |
| NPI Number | 1336200344 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 08/23/2010 |
| Medicare PECOS PAC ID | 7719897263 |
|---|---|
| Medicare Enrollment ID | O20101022000607 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336200344 | NPI | - | NPPES |
| 0034632000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 14 (West Virginia) | Primary |
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