MEDICARE: PREMISE HEALTH OF WEST VIRGINIA MEDICAL, MEDICAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1790155497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMISE HEALTH OF WEST VIRGINIA MEDICAL, MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	5500 MARYLAND WAY STE 120
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-4993
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5005 GREENBAG RD
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26501-7124
Country	:	US
Telephone Number	:	304-554-5012
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EDWARD WILLIAM SCHWARTZ
Credential	:
Telephone Number	:	844-407-7557

Provider Enumeration Date	:	10/07/2015
Last Update Date	:	02/17/2026

Similar Medicare Providers

1669584751 — DR. ALICIA D. HANNA O.D.
Practice Location Address:

5005 GREENBAG RD
MORGANTOWN, WV
26501-7124

Practice Phone: 304-292-4896
Practice Fax:

1366895757 — ISABELA NEGRIN MD
Practice Location Address:

6040 UNIVERSITY TOWN CENTRE DR , PEDIATRICS SUITE
MORGANTOWN, WV
26501-2421

Practice Phone: 304-598-4835
Practice Fax: 304-285-7388

1265384457 — KATELYND N RAUSCHER
Practice Location Address:

5000 GREENBAG RD
MORGANTOWN, WV
26501-7163

Practice Phone: 304-296-9812
Practice Fax:

1154698199 — SHELLEY D ROWAN FNP
Practice Location Address:

215 DON KNOTTS BLVD STE 130
MORGANTOWN, WV
26501-6734

Practice Phone: 304-322-2080
Practice Fax: 304-322-2080

1932051596 — DANIEL BONSIGNORE DPT
Practice Location Address:

4783 DENTS RUN BLVD
MORGANTOWN, WV
26501-2455

Practice Phone: 304-292-0173
Practice Fax:

1043752744 — RYAN JEFFREY DALLATORE LPC
Practice Location Address:

652 MADIGAN AVE
MORGANTOWN, WV
26501-6716

Practice Phone: 304-777-8227
Practice Fax:

Directions to “PREMISE HEALTH OF WEST VIRGINIA MEDICAL, MEDICAL CORPORATION ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.