Organization
RALEIGH COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE BAILEY (MEDICAID SPECIALIST)
(304) 256-4712
Entity
Organization
Contact information
Practice address
105 ADAIR ST, BECKLEY, WV 25801-3733
(304) 256-4712
(304) 256-4683
Mailing address
400 NEVILLE ST, BECKLEY, WV 25801-4511
(304) 256-4712
(304) 256-4683
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
WV
Other
Enumeration date
05/15/2007
Last updated
08/22/2020
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