Organization
RAINELLE MEDICAL CENTER INC
Active
Other names
PAAS FQHC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA J BENNETT (CREDENTIALING SPECIALIST)
(304) 438-6188
Entity
Organization
Contact information
Practice address
176 MEDICAL CENTER DR, RAINELLE, WV 25962-1064
(304) 438-6188
(304) 438-4037
Mailing address
176 MEDICAL CENTER DR, RAINELLE, WV 25962-1064
(304) 438-6188
(304) 438-6819
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035037000
—
WV
01
—
CA6655
MEDICARE RAILROAD
WV
01
—
DC3636
MEDICARE RAILROAD
WV
Enumeration date
12/04/2006
Last updated
03/02/2023
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