| Premise Health Of West Virginia Medical, Medical Corporation | |
|
2200 Menelaus Rd Berea KY 40403-9748 | |
| (859) 228-1568 | |
| Not Available |
| Full Name | Premise Health Of West Virginia Medical, Medical Corporation |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2200 Menelaus Rd, Berea, Kentucky |
| Authorized Official Name and Position | Jonathan B Leizman (PRESIDENT) |
| Authorized Official Contact | 2164799063 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premise Health Of West Virginia Medical, Medical Corporation 5500 Maryland Way Brentwood TN 37027-7048 Ph: () - | Premise Health Of West Virginia Medical, Medical Corporation 2200 Menelaus Rd Berea KY 40403-9748 Ph: (859) 228-1568 |
| NPI Number | 1710652326 |
|---|---|
| Provider Enumeration Date | 08/16/2021 |
| Last Update Date | 08/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710652326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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