NPI: 1003218397 · TRIADELPHIA, WV 26059 · Non-Pharmacy Dispensing Site · NPI assigned 09/18/2014
| Authorized Official | MARRA, DANTE (PRESIDENT) |
| NPI Enumeration Date | 09/18/2014 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 12 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99204 | Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity | 12 | 12 | $1K |