| Community Care Of West Virginia, Inc. | |
|
70 Graceland Drive Elkins WV 26241 | |
| (304) 473-5600 | |
| Not Available |
| Full Name | Community Care Of West Virginia, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 70 Graceland Drive, Elkins, West Virginia |
| Authorized Official Name and Position | Hillary Tenney (CREDENTIALING COORTINATOR) |
| Authorized Official Contact | 3043177425 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Care Of West Virginia, Inc. 70 Graceland Drive Elkins WV 26241 Ph: () - | Community Care Of West Virginia, Inc. 70 Graceland Drive Elkins WV 26241 Ph: (304) 473-5600 |
| NPI Number | 1235877267 |
|---|---|
| Provider Enumeration Date | 05/20/2022 |
| Last Update Date | 05/20/2022 |
| Medicare PECOS PAC ID | 0446232987 |
|---|---|
| Medicare Enrollment ID | O20220615003313 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235877267 | NPI | - | NPPES |
| 2427-1445 | Other | WV | BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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