| Community Care Of West Virginia, Inc. | |
|
597 Liberty St West Milford WV 26451-6801 | |
| (304) 745-4568 | |
| (304) 326-3700 |
| Full Name | Community Care Of West Virginia, Inc. |
|---|---|
| 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 |
|---|---|
| Community Care Of West Virginia, Inc. 597 Liberty St West Milford WV 26451-6801 Ph: (304) 745-4568 | Community Care Of West Virginia, Inc. 597 Liberty St West Milford WV 26451-6801 Ph: (304) 745-4568 |
| NPI Number | 1558563734 |
|---|---|
| Provider Enumeration Date | 06/01/2007 |
| Last Update Date | 01/19/2024 |
| Medicare PECOS PAC ID | 0446232987 |
|---|---|
| Medicare Enrollment ID | O20070907000770 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558563734 | NPI | - | NPPES |
| 1558563734 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Washington) | Primary |
Community Care Of West Virginia, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 226 School St, West Milford, WV 26451 Phone: 304-326-7030 Fax: 304-745-4488 |