| Clay-battelle Community Health Center Dental | |
|
5861 Mason Dixon Hwy Blacksville WV 26521 | |
| (304) 432-8211 | |
| (304) 432-8213 |
| Full Name | Clay-battelle Community Health Center Dental |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 5861 Mason Dixon Hwy, Blacksville, West Virginia |
| Authorized Official Name and Position | Rebecca J Thomas (CEO) |
| Authorized Official Contact | 3044328211 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clay-battelle Community Health Center Dental Po Box 72 Blacksville WV 26521-0072 Ph: (304) 432-8211 | Clay-battelle Community Health Center Dental 5861 Mason Dixon Hwy Blacksville WV 26521 Ph: (304) 432-8211 |
| NPI Number | 1902961980 |
|---|---|
| Provider Enumeration Date | 12/27/2006 |
| Last Update Date | 08/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902961980 | NPI | - | NPPES |
| 0035288002 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |