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100 S. Pickens Rd Helvetia WV 26224-0027 | |
(304) 924-6262 | |
(304) 924-5460 |
Full Name | |
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Speciality | Clinic/Center |
Location | 100 S. Pickens Rd, Helvetia, West Virginia |
Authorized Official Name and Position | Dora L Potasnik (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 3049246262 |
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 | 100 S. Pickens Rd Helvetia WV 26224-0027 Ph: (304) 924-6262 |
NPI Number | 1740310663 |
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Provider Enumeration Date | 03/07/2007 |
Last Update Date | 02/13/2024 |
Medicare PECOS PAC ID | 0446232987 |
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Medicare Enrollment ID | O20070907000780 |
Identifier | Type | State | Issuer |
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1740310663 | NPI | - | NPPES |
0035420000 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (West Virginia) | Primary |