Organization · Type 2 NPI

Community Care of West Virginia, Inc.

Federally Qualified Health Center (FQHC) · Burnsville, WV

NPI number 1871003178 Active

Practice location

228 Kanawha Avenue
Burnsville, WV 26335

Call (304) 924-6262 Map

Fax (304) 924-5460

Mailing address

PO Box 147
Clay, WV 25043-0147

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

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

Another provider at this address

Regina Lenette AllenDoula Sierra Vista, AZ NPI 1881355402

NPI record

NPI: 1871003178
Entity type: Organization (Type 2)
Issued: Oct 2, 2017
Last updated: Oct 2, 2017
Status: Active
Subpart: Yes of Community Care of West Virginia, Inc.

Other names

<unavail>
Burnsville Elementary School Wellness Center · doing business as

Authorized official

Dora L Potasnik
Credentialing Coordinator
(304) 587-2541

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.

Is this your record? How to update it.

About NPI 1871003178

Community Care of West Virginia, Inc.'s National Provider Identifier is 1871003178, issued on Oct 2, 2017. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Burnsville, WV. The record was last updated on Oct 2, 2017.