| Cameron Community Health Center Inc | |
|
Rd# 4 Box 19 Wilson Drive Cameron Community Health Center Inc Cameron WV 26033-9520 | |
| (304) 686-3376 | |
| (304) 686-3646 |
| Full Name | Cameron Community Health Center Inc |
|---|---|
| Speciality | Family Medicine |
| Location | Rd# 4 Box 19 Wilson Drive, Cameron, West Virginia |
| Authorized Official Name and Position | Jay E Prager (CEO) |
| Authorized Official Contact | 3048433235 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cameron Community Health Center Inc Rd# 4 Box 19 Wilson Drive Cameron WV 26033-9520 Ph: (304) 686-3376 | Cameron Community Health Center Inc Rd# 4 Box 19 Wilson Drive Cameron Community Health Center Inc Cameron WV 26033-9520 Ph: (304) 686-3376 |
| NPI Number | 1396836367 |
|---|---|
| Provider Enumeration Date | 09/27/2006 |
| Last Update Date | 08/19/2013 |
| Medicare PECOS PAC ID | 6709050321 |
|---|---|
| Medicare Enrollment ID | O20111117000084 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396836367 | NPI | - | NPPES |
| 001709737 | Other | WV | BC/BS |
| 0008245000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kelly H Barki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134239130 PECOS PAC ID: 6507897170 Enrollment ID: I20050823000845 |
| Provider Name | Katrina Wasmuth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174913214 PECOS PAC ID: 9931412145 Enrollment ID: I20150716003002 |
| Provider Name | Jared W Bloom |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063799799 PECOS PAC ID: 5698034726 Enrollment ID: I20180118001943 |
Kelly H Barki Do Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Rr 4 Box 19, Cameron, WV 26033 Phone: 304-233-2455 Fax: 304-233-6073 |