Organization
CITY OF SISTERSVILLE
Active
Other names
Sistersville Rural Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON W CHADOCK (AO)
(304) 652-2611
Entity
Organization
Contact information
Practice address
305 CLAY ST, SISTERSVILLE, WV 26175
(304) 447-2038
(304) 447-3990
Mailing address
314 S WELLS ST, SISTERSVILLE, WV 26175-1098
(304) 652-2611
(304) 652-1448
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
513412
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810018439
—
WV
Enumeration date
04/20/2010
Last updated
10/21/2020
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