Organization
GREENBRIER VMC LLC
Active
Other names
Greenbrier Valley Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BREWER (DIRECTOR)
(877) 892-9813
Entity
Organization
Contact information
Practice address
202 MAPLEWOOD AVE, RONCEVERTE, WV 24970-1334
(304) 647-4411
Mailing address
202 MAPLEWOOD AVE, RONCEVERTE, WV 24970
(304) 647-4411
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
2086S0129X
Vascular Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0106041003
—
SC
01
—
CJ9984
MEDICARE RR
—
Enumeration date
08/14/2006
Last updated
12/05/2008
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