| Community Health Center Of Ne Wetzel County | |
|
1855 Hornet Hwy Burton WV 26562-7430 | |
| (304) 775-4671 | |
| (304) 775-4211 |
| Full Name | Community Health Center Of Ne Wetzel County |
|---|---|
| Speciality | Clinic/Center |
| Location | 1855 Hornet Hwy, Burton, West Virginia |
| Authorized Official Name and Position | Rebecca J Thomas (CEO) |
| Authorized Official Contact | 3044328211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Health Center Of Ne Wetzel County 60 May Ln Ste 102 Burton WV 26562-9669 Ph: (304) 775-4671 | Community Health Center Of Ne Wetzel County 1855 Hornet Hwy Burton WV 26562-7430 Ph: (304) 775-4671 |
| NPI Number | 1437214509 |
|---|---|
| Provider Enumeration Date | 12/27/2006 |
| Last Update Date | 08/16/2023 |
| Medicare PECOS PAC ID | 3870495815 |
|---|---|
| Medicare Enrollment ID | O20040121000993 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437214509 | NPI | - | NPPES |
| CN0274 | Other | WV | MEDICARE RR |
| 0035288001 | Medicaid | WV | |
| 001990226 | Other | WV | MS BCBS |
| CN0274 | Other | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Wade Vincent Harvey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457565558 PECOS PAC ID: 7416990007 Enrollment ID: I20090917000619 |
| Provider Name | Richard Olutoyin Ajayi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902875743 PECOS PAC ID: 0042351124 Enrollment ID: I20100112000220 |
| Provider Name | Larry Gitelman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568438539 PECOS PAC ID: 2365548708 Enrollment ID: I20110701000296 |
| Provider Name | Shawna Cogar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184169666 PECOS PAC ID: 6800261801 Enrollment ID: I20230405000135 |
Community Health Center Of Ne Wetzel County Lab Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1855 Hornet Hwy, Burton, WV 26562 Phone: 304-775-4671 Fax: 304-775-4211 |