| Community Care Of West Virginia, Inc. | |
|
Rr 1 Box 10a Salem WV 26426-9703 | |
| (304) 316-7180 | |
| (304) 924-5460 |
| Full Name | Community Care Of West Virginia, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | Rr 1 Box 10a, Salem, 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 |
|---|---|
| Community Care Of West Virginia, Inc. Po Box 217 Rock Cave WV 26234-0217 Ph: (304) 924-6262 | Community Care Of West Virginia, Inc. Rr 1 Box 10a Salem WV 26426-9703 Ph: (304) 316-7180 |
| NPI Number | 1558752824 |
|---|---|
| Provider Enumeration Date | 02/09/2015 |
| Last Update Date | 02/09/2015 |
| Medicare PECOS PAC ID | 0446232987 |
|---|---|
| Medicare Enrollment ID | O20150326000961 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558752824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (West Virginia) | Primary |
Salem Family Medicine Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Rr 1 Box 75-1, Old Route 50 West, Salem, WV 26426 Phone: 304-782-2000 |