| Buckhannon Upshur Middle School Wellness Center | |
|
Rr 6 Box 303 Buckhannon WV 26201-8830 | |
| (304) 472-1520 | |
| (304) 472-6864 |
| Full Name | Buckhannon Upshur Middle School Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | Rr 6 Box 303, Buckhannon, West Virginia |
| Authorized Official Name and Position | Dora L Potasnik (CREDENTIALING) |
| Authorized Official Contact | 3045872541 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Buckhannon Upshur Middle School Wellness Center Po Box 217 Rock Cave WV 26234-0217 Ph: (304) 924-6262 | Buckhannon Upshur Middle School Wellness Center Rr 6 Box 303 Buckhannon WV 26201-8830 Ph: (304) 472-1520 |
| NPI Number | 1992144273 |
|---|---|
| Provider Enumeration Date | 06/19/2013 |
| Last Update Date | 06/19/2013 |
| Medicare PECOS PAC ID | 0446232987 |
|---|---|
| Medicare Enrollment ID | O20131029001913 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992144273 | NPI | - | NPPES |
| 2287-7374 | Other | WV | BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 2287-7364 (West Virginia) | Primary |
| Provider Name | Iris Mae Canete Trinidad Carillo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386873024 PECOS PAC ID: 3375791726 Enrollment ID: I20120910000910 |
Community Care Of West Virginia, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 34 N Kanawha St, Buckhannon, WV 26201 Phone: 304-924-6262 Fax: 304-924-6699 | |
Buckhannon-upshur High School Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 50 Bu Dr, Buckhannon, WV 26201 Phone: 304-472-3720 Fax: 304-472-0772 | |
Carexpress Of Buckhannon Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 77 W Main St, Buckhannon, WV 26201 Phone: 304-473-5600 Fax: 304-472-1341 | |
Community Care Of West Virginia, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 33 E Victoria St, Buckhannon, WV 26201 Phone: 304-924-6262 Fax: 304-924-5460 | |
Community Care Pediatrics Of Buckhannon Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4 Northridge Dr Ste 118, Buckhannon, WV 26201 Phone: 304-473-5660 Fax: 304-473-5661 | |
St. Joseph's Physician Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Amalia Dr, Suite B-1, Buckhannon, WV 26201 Phone: 304-473-2200 Fax: 304-473-2057 | |
West Virginia Wesleyan College Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 59 College Ave, Buckhannon, WV 26201 Phone: 304-924-6262 Fax: 304-924-5460 |