| Community Care Of Rock Cave | |
|
78 Queens Alley Rd Rock Cave WV 26234-5890 | |
| (304) 924-6262 | |
| (304) 924-5460 |
| Full Name | Community Care Of Rock Cave |
|---|---|
| Speciality | Clinic/Center |
| Location | 78 Queens Alley Rd, Rock Cave, West Virginia |
| Authorized Official Name and Position | Dora L Potasnik (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 3073177275 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Care Of Rock Cave Po Box 217 Rock Cave WV 26234-0217 Ph: (304) 924-6262 | Community Care Of Rock Cave 78 Queens Alley Rd Rock Cave WV 26234-5890 Ph: (304) 924-6262 |
| NPI Number | 1912932526 |
|---|---|
| Provider Enumeration Date | 07/11/2006 |
| Last Update Date | 01/18/2024 |
| Medicare PECOS PAC ID | 0446232987 |
|---|---|
| Medicare Enrollment ID | O20070310000109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912932526 | NPI | - | NPPES |
| 001709743 | Other | WV | MS BCBS |
| 1912932526 | Medicaid | WV | |
| CL3758 | Other | WV | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (West Virginia) | Primary |
Rock Cave Elementary School Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12292 Wv-20, Rock Cave, WV 26234 Phone: 304-924-5920 Fax: 304-924-5922 |