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Hc 61 Box 14 Frametown WV 26623-9401 | |
(304) 364-5526 | |
(304) 364-8620 |
Full Name | |
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Speciality | Clinic/Center |
Location | Hc 61 Box 14, Frametown, West Virginia |
Authorized Official Name and Position | Dora L Potasnik (CREDENTIALING) |
Authorized Official Contact | 3045872541 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 217 Rock Cave WV 26234-0217 Ph: (304) 924-6262 | Hc 61 Box 14 Frametown WV 26623-9401 Ph: (304) 364-5526 |
NPI Number | 1790110047 |
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Provider Enumeration Date | 09/05/2013 |
Last Update Date | 09/05/2013 |
Medicare PECOS PAC ID | 0446232987 |
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Medicare Enrollment ID | O20140312000219 |
Identifier | Type | State | Issuer |
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1790110047 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |