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NPI Code Detail

MEDICARE: GREENBRIER CLINIC, INC.

MEDICARE: GREENBRIER CLINIC, INC.
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
1207RC0000XCardiovascular Disease Physician
2207RE0101XEndocrinology, Diabetes & Metabolism Physician
3207RG0100XGastroenterology Physician
4207RP1001XPulmonary Disease Physician
52085R0202XDiagnostic Radiology Physician
6207R00000XInternal Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CB4426OTHERWVRAILROAD PTAN

General Provider Information

NPI Number : 1043258783
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREENBRIER CLINIC, INC.
Provider Business Mailing Address
First Line : 320 WEST MAIN ST
Second Line :
City : WHITE SULPHUR SPRINGS
State : WV
Zip : 24986-2414
Country : US
Telephone Number : 304-536-4870
Fax Number : 304-536-8010
Provider Business Practice Location Address
First Line : 320 WEST MAIN ST
Second Line :
City : WHITE SULPHUR SPRINGS
State : WV
Zip : 24986-2414
Country : US
Telephone Number : 304-536-4870
Fax Number : 304-536-8010
Authorized Official
Title or Position : ADMINISTRATOR
Name : N ED JONES
Credential :
Telephone Number : 304-536-4870
Provider Enumeration Date : 06/03/2006
Last Update Date : 01/09/2008

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Directions to “GREENBRIER CLINIC, INC. ” Practice Location

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