| Community Care Of Green Bank | |
|
90 Route 28 Green Bank WV 24944-0085 | |
| (304) 456-5115 | |
| (304) 456-5117 |
| Full Name | Community Care Of Green Bank |
|---|---|
| Speciality | Clinic/Center |
| Location | 90 Route 28, Green Bank, West Virginia |
| Authorized Official Name and Position | Connie Simmons (COO CFO) |
| Authorized Official Contact | 3049246262 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Care Of Green Bank Po Box 217 Rock Cave WV 26234 Ph: (304) 924-6262 | Community Care Of Green Bank 90 Route 28 Green Bank WV 24944-0085 Ph: (304) 456-5115 |
| NPI Number | 1164557237 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 01/25/2012 |
| Medicare PECOS PAC ID | 0446232987 |
|---|---|
| Medicare Enrollment ID | O20071018000710 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164557237 | NPI | - | NPPES |
| 3810010087 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (West Virginia) | Primary |
Green Bank Elementary-middle School Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: Rr 1 Box 5, Green Bank, WV 24944 Phone: 304-456-4865 Fax: 304-456-5162 | |
Pocahontas Medical Clinics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Route 92, Green Bank, WV 24944 Phone: 304-456-4211 Fax: 304-456-5213 |