Organization
RAINELLE MEDICAL CENTER INC
Active
Organization
RAINELLE MEDICAL CENTER INC
Active
Other names
Meadow Bridge Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA J BENNETT (CREDENTIALING SPECIALIST)
(304) 438-6188
Entity
Organization
Contact information
Practice address
8971 SEWELL CREEK ROAD, MEADOW BRIDGE, WV 25976
(304) 484-7755
(304) 484-6205
Mailing address
1502 MEADOW BRIDGE RD, MEADOW BRIDGE, WV 25976-9655
(304) 484-7755
(304) 484-6205
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035241003
—
WV
Enumeration date
12/04/2006
Last updated
11/16/2023
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