Mercer County Health Department
Organization Active NPI Primary Care Clinic/Center · Bluefield, WV
NPI 1861696601 · NPPES record last updated Mar 24, 2015
Key facts
- NPI
- 1861696601
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- MERCER COUNTY HEALTH DEPARTMENT
- Practice address
- 978 Blue Prince Rd
Bluefield, WV 24701-5074 - Phone
- (304) 324-8367
- Fax
- (304) 324-8843
- NPI assigned
- Jun 14, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Phyllis Susan Kadar
- Title
- Administrator
- Phone
- (304) 324-8367
Practitioners 5
-
Robert Lee Snidow Jr., M.D.
-
Christie Ann Hill-Hurt, PHYSICIAN ASSISTANT
-
Whitney Crook, NP-C
-
Mario Lucero, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WV
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110825000087 | WV | Part B Supplier - Clinic/Group Practice | 4284675448 |
Receives reassigned benefits from 5 practitioners Practice locations: Bluefield, WV |
National Provider Directory
Locations
1331 Southview Dr
Ste 9
Bluefield, WV 24701
Phone (304) 324-8367
978 Blue Prince Rd
Bluefield, WV 24701
Phone (304) 324-8367
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | Yes |
Addresses
Primary practice location
978 Blue Prince Rd
Bluefield, WV 24701-5074
Mailing address
978 Blue Prince Rd
Bluefield, WV 24701-5074
Phone (304) 324-8367
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001711297 | Other | WV | BLUE CROSS BLUE SHIELD |
| 1540381 | Other | WV | UMWA PROVIDER NUMBER |
| 0021320000 | Medicaid | WV |
Other providers in Bluefield, WV
- Makayla Joyce McReynolds
- Aaron William Meadows
- Brian Meadows
- Ella Marie Meadows
- Katie Melara
- Mercer Nursing & Rehabilitation Center LLC
- Mercer SNF LLC
- Annette Marie Merz
- Michael T. Hegstrom,MD, PLLC
- Leslie Mills
All providers in Bluefield, WV · Primary Care Clinic/Center in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.