Organization
SUMMERSVILLE OUT PATIENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE HILL MBA (CEO)
(304) 872-8402
Entity
Organization
Contact information
Practice address
400 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 26651-9308
(304) 872-5124
(304) 872-0675
Mailing address
400 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 26651-9308
(304) 872-5124
(304) 872-0675
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
61
WV
261QM1300X
Multi-Specialty Clinic/Center
61
WV
291U00000X
Clinical Medical Laboratory
51D0933140
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0034931000
—
WV
05
—
0034931003
—
WV
Enumeration date
09/29/2005
Last updated
09/22/2010
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