Community Care of West Virginia, Inc.

NPI #1821349309 in West Milford, West Virginia

Provider Information

NPI Number
1821349309
Entity Type
Organization
Organization Name
Community Care of West Virginia, Inc.
Subpart
Yes (part of a larger organization)
Parent Organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Primary Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date
Sep 25, 2012
Last Updated
Mar 21, 2019

Practice Location

Address
226 SCHOOL ST
ZIP Code
26451-9700
Phone
(304) 326-7030

Authorized Official

Name
DORA L POTASNIK
Title
CREDENTIALING COORDINATOR
Phone
(304) 561-5319

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)Federally Qualified Health Center (FQHC)

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