Community Care Of West Milford | |
597 Liberty St West Milford WV 26451-6801 | |
(304) 745-4568 | |
(304) 326-3700 |
Full Name | Community Care Of West Milford |
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Speciality | Clinic/Center |
Location | 597 Liberty St, West Milford, West Virginia |
Authorized Official Name and Position | Dora L Potasnik (CREDENTIALING COORDINATOR) |
Authorized Official Contact | 3043177275 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Community Care Of West Milford 597 Liberty St West Milford WV 26451-6801 Ph: (304) 745-4568 | Community Care Of West Milford 597 Liberty St West Milford WV 26451-6801 Ph: (304) 745-4568 |
NPI Number | 1558563734 |
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Provider Enumeration Date | 06/01/2007 |
Last Update Date | 01/19/2024 |
Medicare PECOS PAC ID | 0446232987 |
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Medicare Enrollment ID | O20070907000770 |
Identifier | Type | State | Issuer |
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1558563734 | NPI | - | NPPES |
1558563734 | Medicaid | WV |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Washington) | Primary |
West Milford Elementary School Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 226 School St, West Milford, WV 26451 Phone: 304-326-7030 Fax: 304-745-4488 |