| Community Care Of Buckhannon | |
|
33-37 W Main Street Buckhannon WV 26201-2235 | |
| (304) 924-6262 | |
| (304) 924-5460 |
| Full Name | Community Care Of Buckhannon |
|---|---|
| Speciality | Clinic/Center |
| Location | 33-37 W Main Street, Buckhannon, West Virginia |
| Authorized Official Name and Position | Dora L Potasnik (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 3045872541 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Care Of Buckhannon 33-37 W Main Street Buckhannon WV 26201-2236 Ph: (304) 924-6262 | Community Care Of Buckhannon 33-37 W Main Street Buckhannon WV 26201-2235 Ph: (304) 924-6262 |
| NPI Number | 1891241030 |
|---|---|
| Provider Enumeration Date | 08/28/2016 |
| Last Update Date | 11/29/2022 |
| Medicare PECOS PAC ID | 0446232987 |
|---|---|
| Medicare Enrollment ID | O20161012002394 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891241030 | NPI | - | NPPES |
| 2289-7283 | Other | WV | STATE OF WV BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 2289-7283 (West Virginia) | Primary |
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