<unavail> in Bridgeport, WV - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Bridgeport, West Virginia. The current practice location for is 65 Professional Pl Ste 102103, Bridgeport, West Virginia. For appointments, you can reach them via phone at (304) 848-5770. The mailing address for is Po Box 217, Rock Cave, West Virginia and phone number is (304) 924-6262.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1619348844. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (304) 848-5770.

Contact Information


	65 Professional Pl Ste 102103 Bridgeport WV 26330-0258
	(304) 848-5770
	(304) 848-0890

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	65 Professional Pl Ste 102103, Bridgeport, 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 and Practice Location

Mailing Address	Practice Location Address
Po Box 217 Rock Cave WV 26234-0217 Ph: (304) 924-6262	65 Professional Pl Ste 102103 Bridgeport WV 26330-0258 Ph: (304) 848-5770

NPI Details:

NPI Number	1619348844
Provider Enumeration Date	10/14/2015
Last Update Date	02/20/2019

Medicare PECOS Information:

Medicare PECOS PAC ID	0446232987
Medicare Enrollment ID	O20151024000211

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1619348844	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QF0400X	Clinic/center - Federally Qualified Health Center (fqhc)	(* (Not Available))	Primary

Reviews and Comments

Clinic/Center in Bridgeport, WV

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- Medicare Primary Care in Bridgeport, WV