# CITY OF SISTERSVILLE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sistersville Rural Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710203419
- **Authorized official:** BRANDON W CHADOCK (AO)
- **Authorized official phone:** (304) 652-2611

## Contact information

- **Practice address:** 305 CLAY ST, SISTERSVILLE, WV 26175
- **Practice address phone:** (304) 447-2038
- **Practice address fax:** (304) 447-3990
- **Mailing address:** 314 S WELLS ST, SISTERSVILLE, WV 26175-1098
- **Mailing address phone:** (304) 652-2611
- **Mailing address fax:** (304) 652-1448

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 513412 | WV | Yes |

## Other

- **Enumeration date:** 04/20/2010
- **Last updated:** 10/21/2020