COMMUNITY CARE OF WEST VIRGINIA INC. NPI 1912392358

NPI Information

NPI: 1912392358
Provider Name: COMMUNITY CARE OF WEST VIRGINIA, INC.

Doing Business As: JOHNSON ELEMENTARY SCHOOL WELLNESS CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
531 JOHNSON AVE
BRIDGEPORT, WV
ZIP 26330
Phone: (304) 326-7109
Get Directions

COMMUNITY CARE OF WEST VIRGINIA, INC. is a federally qualified health center (fqhc) clinic center in Bridgeport, WV. COMMUNITY CARE OF WEST VIRGINIA, INC. NPI is 1912392358. The provider is registered as an organization entity type.
The provider Is Doing Business As Johnson Elementary School Wellness Center.

The provider's business location address is:

531 JOHNSON AVE
BRIDGEPORT, WV
ZIP 26330-311
Phone: (304) 326-7109
Fax: (304) 587-2594

The provider's authorized official is Dora L Potasnik .
The authorized official title is Credentialing and has the following contact phone number (304) 587-2541.

The enumeration date for this NPI number is 4/2/2015 and was last updated on 4/2/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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