Community Care Of West Virginia, Inc. | |
5078 Tallmansville Rd Buckhannon WV 26201-1687 | |
(304) 924-6262 | |
(304) 924-5460 |
Full Name | Community Care Of West Virginia, Inc. |
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Speciality | Clinic/Center |
Location | 5078 Tallmansville Rd, Buckhannon, West Virginia |
Authorized Official Name and Position | Dora L Potasnik (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 3045615319 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Community Care Of West Virginia, Inc. 5078 Tallmansville Rd Buckhannon WV 26201-1687 Ph: (304) 924-6262 | Community Care Of West Virginia, Inc. 5078 Tallmansville Rd Buckhannon WV 26201-1687 Ph: (304) 924-6262 |
NPI Number | 1710539630 |
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Provider Enumeration Date | 07/11/2019 |
Last Update Date | 07/11/2019 |
Medicare PECOS PAC ID | 0446232987 |
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Medicare Enrollment ID | O20190829002259 |
Identifier | Type | State | Issuer |
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1710539630 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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 | |
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 | |