| Washington Irving Middle School Wellness Center | |
|
443 Lee Ave Clarksburg WV 26301-3648 | |
| (304) 326-7420 | |
| (304) 624-3388 |
| Full Name | Washington Irving Middle School Wellness Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 443 Lee Ave, Clarksburg, 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 |
|---|---|
| Washington Irving Middle School Wellness Center Po Box 217 Rock Cave WV 26234-0217 Ph: (304) 924-6262 | Washington Irving Middle School Wellness Center 443 Lee Ave Clarksburg WV 26301-3648 Ph: (304) 326-7420 |
| NPI Number | 1619316999 |
|---|---|
| Provider Enumeration Date | 06/19/2013 |
| Last Update Date | 06/19/2013 |
| Medicare PECOS PAC ID | 0446232987 |
|---|---|
| Medicare Enrollment ID | O20131108001807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619316999 | NPI | - | NPPES |
| 2287-8809 | Other | WV | BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 2287-8809 (West Virginia) | Primary |
Community Care of Clarksburg Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 700 Oakmound Rd, Clarksburg, WV 26301 Phone: 304-924-6262 Fax: 304-924-5460 |
Veterans Health Administration Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Med Center Dr, Clarksburg, WV 26301 Phone: 304-623-3461 |
Ucfa Physicians Network Group of West Virginia Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2413 E Pike St, Clarksburg, WV 26301 Phone: 423-271-9911 |
Mountaineer Elementary School Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2 Mountaineer Dr, Clarksburg, WV 26301 Phone: 304-326-7620 Fax: 304-924-5460 |
Liberty Middle School Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1 Mountaineer Dr, Clarksburg, WV 26301 Phone: 304-326-7470 Fax: 304-587-2594 |
North View Elementary School Wellness Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1400 N 19th St, Clarksburg, WV 26301 Phone: 304-326-7650 Fax: 304-587-2594 |