| Peterson-central Elementary School Wellness Center | |
|
509 Berlin Rd Weston WV 26452-8323 | |
| (304) 269-0029 | |
| (304) 269-0040 |
| Full Name | Peterson-central Elementary School Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 509 Berlin Rd, Weston, 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 |
|---|---|
| Peterson-central Elementary School Wellness Center Po Box 217 Rock Cave WV 26234-0217 Ph: (304) 924-6262 | Peterson-central Elementary School Wellness Center 509 Berlin Rd Weston WV 26452-8323 Ph: (304) 269-0029 |
| NPI Number | 1841666807 |
|---|---|
| Provider Enumeration Date | 08/13/2015 |
| Last Update Date | 08/25/2015 |
| Medicare PECOS PAC ID | 0446232987 |
|---|---|
| Medicare Enrollment ID | O20151006000030 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841666807 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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