| Liberty High School Wellness Center | |
|
1 Mountaineer Dr Clarksburg WV 26301-5511 | |
| (304) 326-7470 | |
| (304) 587-2594 |
| Full Name | Liberty High School Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 Mountaineer Dr, Clarksburg, 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 |
|---|---|
| Liberty High School Wellness Center Po Box 147 Clay WV 25043-0147 Ph: (304) 587-2541 | Liberty High School Wellness Center 1 Mountaineer Dr Clarksburg WV 26301-5511 Ph: (304) 326-7470 |
| NPI Number | 1194111468 |
|---|---|
| Provider Enumeration Date | 04/13/2015 |
| Last Update Date | 04/13/2015 |
| Medicare PECOS PAC ID | 0446232987 |
|---|---|
| Medicare Enrollment ID | O20150601001383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194111468 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Community Care Of Clarksburg Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 700 Oakmound Rd, Clarksburg, WV 26301 Phone: 304-924-6262 Fax: 304-924-5460 | |
Veterans Health Administration Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Med Center Dr, Clarksburg, WV 26301 Phone: 304-623-3461 | |
Ucfa Physicians Network Group Of West Virginia Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2413 E Pike St, Clarksburg, WV 26301 Phone: 423-271-9911 | |
Mountaineer Middle School Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2 Mountaineer Dr, Clarksburg, WV 26301 Phone: 304-326-7620 Fax: 304-924-5460 | |
North View Elementary School Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1400 N 19th St, Clarksburg, WV 26301 Phone: 304-326-7650 Fax: 304-587-2594 | |
Robert C. Byrd High Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1 Eagle Way, Clarksburg, WV 26301 Phone: 304-326-7200 Fax: 304-624-3211 |