| Burnsville Elementary School Wellness Center | |
|
228 Kanawha Avenue Burnsville WV 26335 | |
| (304) 924-6262 | |
| (304) 924-5460 |
| Full Name | Burnsville Elementary School Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 228 Kanawha Avenue, Burnsville, West Virginia |
| Authorized Official Name and Position | Dora L Potasnik (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 3045872541 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Burnsville Elementary School Wellness Center Po Box 147 Clay WV 25043-0147 Ph: (304) 587-2541 | Burnsville Elementary School Wellness Center 228 Kanawha Avenue Burnsville WV 26335 Ph: (304) 924-6262 |
| NPI Number | 1871003178 |
|---|---|
| Provider Enumeration Date | 10/02/2017 |
| Last Update Date | 10/02/2017 |
| Medicare PECOS PAC ID | 0446232987 |
|---|---|
| Medicare Enrollment ID | O20171116003214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871003178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Braxton Primary Health Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 110 Municipal Street, Burnsville, WV 26335 Phone: 304-853-2278 Fax: 304-853-2520 |