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Organization

ALLEGHANY MEDICAL SERVICES PC

Active
Other names
Rupert Primary Care
Organization subpart
No

Provider details

NPI number
Authorized official
J JORGE GORDINHO MD (SUPERVISOR PHYSICIAN OWNER)
(304) 254-9022
Entity
Organization

Contact information

Practice address
1109 GREENBIER ST, RUPERT, WV 25984
(304) 392-5381
(304) 392-5351
Mailing address
310 GEORGE ST, BECKLEY, WV 25801-2653
(304) 254-9022
(304) 254-9024

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
261QR1300X
Rural Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0072202000
WV
05
3810006041
WV
05
5303001000
WV
01
CK7027
RAILROAD MEDICARE
WV
01
P00177367
RAILROAD MEDICARE
WV
Enumeration date
08/14/2006
Last updated
04/16/2008
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