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Organization

COMMUNITY CARE OF WEST VIRGINIA, INC.

Active
Parent organization
COMMUNITY CARE OF WEST VIRGINIA, INC.
Other names
Buckhannon-Upshur High School Wellness Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
COMMUNITY CARE OF WEST VIRGINIA, INC.
Authorized official
RICHARD G SIMON (CEO)
(304) 924-6262
Entity
Organization

Contact information

Practice address
50 BU DR, BUCKHANNON, WV 26201-9411
(304) 472-3720
(304) 472-0772
Mailing address
50 BU DR, BUCKHANNON, WV 26201-9411
(304) 472-3720
(304) 472-0772

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
2273-6226
WV

Other

Enumeration date
09/25/2012
Last updated
10/02/2012
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