Potomac Highlands Guild

LBN: Potomac Highlands Guild
Potomac Highlands Guild is an health care organization with primary practice located at 6 Park St , Petersburg WV 26847-1765. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Potomac Highlands Guild can be contacted via phone (304) 257-1155, or through Raines, Frederick S. via phone (304) 257-1155.

Contact Information

Primary practice address
6 Park St Petersburg WV 26847-1765
Phone: (304) 257-1155
Fax: (304) 257-1945
Website:
Map and Directions
Authorized official contact:
Name: Raines, Frederick S. Doctor of Medicine (MD)
Phone: (304) 257-1155

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X 14000 West Virginia

Profile Details

NPI number 1720273170
LBN Legal business name Potomac Highlands Guild
DBA Doing business as
Authorized official Raines, Frederick S. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 10th, 2007
Last updated Sep 10th, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720273170 NPPES
West Virginia MEDICAID 0005473000

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