Community Care of West Virginia, Inc.

NPI #1851767818 in Jane Lew, West Virginia

Provider Information

NPI Number
1851767818
Entity Type
Organization
Organization Name
Community Care of West Virginia, Inc.
Primary Specialty
Clinic/Center - Federally Qualified Health Center (FQHC)
Enumeration Date
Aug 13, 2015
Last Updated
Aug 25, 2015

Practice Location

Address
6536 MAIN ST
ZIP Code
26378-8505
Phone
(304) 884-2307

Authorized Official

Name
DORA L POTASNIK
Title
CREDENTIALING
Phone
(304) 587-2541

Specialties & Taxonomy Codes

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

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