Organization
ST GEORGE MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL H WAMSLEY JR. (EXECUTIVE DIRECTOR)
(304) 478-3339
Entity
Organization
Contact information
Practice address
81 TUCKER VALLEY SCHOOL RD, HAMBLETON, WV 26269-8052
(304) 478-3339
Mailing address
6420 HOLLY MEADOWS RD, PARSONS, WV 26287-8055
(304) 478-3339
(304) 478-3311
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000
UNKNOW
—
Enumeration date
06/12/2015
Last updated
06/12/2015
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