<unavail> in Bridgeport, WV - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Bridgeport, West Virginia. The current practice location for is 601 Johnson Ave, Bridgeport, West Virginia. For appointments, you can reach them via phone at (304) 842-2747. The mailing address for is 601 Johnson Ave, Bridgeport, West Virginia and phone number is (304) 842-2747.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1912392358. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (304) 842-2747.

Contact Information


	601 Johnson Ave Bridgeport WV 26330-1971
	(304) 842-2747
	(304) 623-6220

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	601 Johnson Ave, Bridgeport, West Virginia
Authorized Official Name and Position	Dora L Potasnik (CREDENTIALING)
Authorized Official Contact	3043177275
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
601 Johnson Ave Bridgeport WV 26330-1971 Ph: (304) 842-2747	601 Johnson Ave Bridgeport WV 26330-1971 Ph: (304) 842-2747

NPI Details:

NPI Number	1912392358
Provider Enumeration Date	04/02/2015
Last Update Date	07/25/2023

Medicare PECOS Information:

Medicare PECOS PAC ID	0446232987
Medicare Enrollment ID	O20150521002696

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1912392358	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QF0400X	Clinic/center - Federally Qualified Health Center (fqhc)	(* (Not Available))	Primary

Reviews and Comments

Clinic/Center in Bridgeport, WV

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Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1221 Johnson Ave, Suite 1100, Bridgeport, WV 26330 Phone: 304-848-0338
Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 515 Johnston Avenue, Bridgeport, WV 26330 Phone: 304-326-7137 Fax: 304-587-2594

- Medicare Primary Care in Bridgeport, WV