Organization · Type 2 NPI

Community Care of West Virginia, Inc.

Federally Qualified Health Center (FQHC) · Lost Creek, WV

NPI number 1699024547 Active

Practice location

RR 1 Box 58B
Lost Creek, WV 26385-9707

Fax (304) 745-5587

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	2273-6225 (WV)

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

Other federally qualified health center (fqhc) providers in Lost Creek

Community Care of West Virginia, Inc.Federally Qualified Health Center (FQHC) Lost Creek, WV NPI 1912258492

See all in Lost Creek →

NPI record

NPI: 1699024547
Entity type: Organization (Type 2)
Issued: Sep 6, 2012
Last updated: Mar 21, 2019
Status: Active
Subpart: Yes of Community Care of West Virginia, Inc.

Other names

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South Harrison Middle School Wellness Center · doing business as
South Harrison Middle School Wellness Center · doing business as

Authorized official

Dora L Potasnik
Credentialing Coordinator
(304) 561-5319

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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 1699024547

Community Care of West Virginia, Inc.'s National Provider Identifier is 1699024547, issued on Sep 6, 2012. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Lost Creek, WV. The record was last updated on Mar 21, 2019.