Organization · Type 2 NPI

Community Care of West Virginia, Inc.

Federally Qualified Health Center (FQHC) · Buckhannon, WV

NPI number 1104177674 Active

Practice location

50 Bu Dr
Buckhannon, WV 26201-9411

Fax (304) 472-0772

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	2273-6226 (WV)

Federally Qualified Health Center (FQHC): Definition to come...

Another provider at this address

Genevieve F. Larimer Dunn, FNP-BCFamily Nurse Practitioner Buckhannon, WV NPI 1861708513

Other federally qualified health center (fqhc) providers in Buckhannon

See all in Buckhannon →

NPI record

NPI: 1104177674
Entity type: Organization (Type 2)
Issued: Sep 25, 2012
Last updated: Oct 2, 2012
Status: Active
Subpart: Yes of Community Care of West Virginia, Inc.

Other names

<unavail>
Buckhannon-Upshur High School Wellness Center · doing business as

Authorized official

Richard G Simon
CEO
(304) 924-6262

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104177674

Community Care of West Virginia, Inc.'s National Provider Identifier is 1104177674, issued on Sep 25, 2012. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Buckhannon, WV. The record was last updated on Oct 2, 2012.