Organization
SHENANDOAH VALLEY FAMILY HEALTH CENTER
Active
Organization
SHENANDOAH VALLEY FAMILY HEALTH CENTER
Active
Other names
Shenandoah Valley Medical System,Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FANT (CEO)
(304) 263-4999
Entity
Organization
Contact information
Practice address
102 HOVATER DRIVE, INWOOD, WV 25428
(304) 263-4999
(304) 263-0984
Mailing address
PO BOX 1146, MARTINSBURG, WV 25402-1146
(304) 263-4999
(304) 263-0984
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035217007
—
WV
Enumeration date
07/13/2007
Last updated
05/21/2008
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