Organization
ALLEGHANY MEDICAL SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE JORGE GORDINHO M.D. (PRESIDENT/OWNER)
(304) 254-9022
Entity
Organization
Contact information
Practice address
1 ARH LANE, SUITE 100, LOW MOOR, VA 24457
(540) 862-6520
(540) 862-3538
Mailing address
310 GEORGE ST, BECKLEY, WV 25801-2653
(304) 254-9022
(304) 254-9024
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005806437
—
VA
05
—
0070431000
—
WV
05
—
0072202000
—
WV
01
—
110157801
RAILROAD MEDICARE
WV
05
—
3810006041
—
WV
01
—
CE9629
RAILROAD MEDICARE
WV
01
—
CK7027
RAILROAD MEDICARE
WV
01
—
P00106734
RAILROAD MEDICARE
WV
01
—
P00177367
RAILROAD MEDICARE
—
Enumeration date
09/05/2006
Last updated
07/12/2011
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