| Wirt County School Wellness Center | |
|
Schoolview Street Elizabeth WV 26143 | |
| (304) 275-3117 | |
| (304) 275-3117 |
| Full Name | Wirt County School Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | Schoolview Street, Elizabeth, West Virginia |
| Authorized Official Name and Position | Vicki L Knicely (BILLING/CREDENTIALING SUPERVISOR) |
| Authorized Official Contact | 3042753301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wirt County School Wellness Center Po Box 609 Elizabeth WV 26143-0609 Ph: (304) 275-3301 | Wirt County School Wellness Center Schoolview Street Elizabeth WV 26143 Ph: (304) 275-3117 |
| NPI Number | 1518191923 |
|---|---|
| Provider Enumeration Date | 05/13/2009 |
| Last Update Date | 01/03/2014 |
| Medicare PECOS PAC ID | 7810806577 |
|---|---|
| Medicare Enrollment ID | O20140610001405 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518191923 | NPI | - | NPPES |
| 0009486002 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (West Virginia) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
James R. Toothman Do Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 83 Little Kanawha Pkwy, Elizabeth, WV 26143 Phone: 304-422-3904 | |
Wirt County Family Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 483 Court Street, Elizabeth, WV 26143 Phone: 304-275-3301 Fax: 304-275-4798 |