| Robert C. Byrd High Wellness Center | |
|
1 Eagle Way Clarksburg WV 26301-9784 | |
| (304) 326-7200 | |
| (304) 624-3211 |
| Full Name | Robert C. Byrd High Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1 Eagle Way, 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 |
|---|---|
| Robert C. Byrd High Wellness Center Po Box 217 Rock Cave WV 26234-0217 Ph: (304) 924-6262 | Robert C. Byrd High Wellness Center 1 Eagle Way Clarksburg WV 26301-9784 Ph: (304) 326-7200 |
| NPI Number | 1356780639 |
|---|---|
| Provider Enumeration Date | 06/19/2013 |
| Last Update Date | 06/19/2013 |
| Medicare PECOS PAC ID | 0446232987 |
|---|---|
| Medicare Enrollment ID | O20131108001893 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356780639 | NPI | - | NPPES |
| 2287-7373 | Other | WV | BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 2287-7373 (West Virginia) | Primary |
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