COMMUNITY CARE OF WEST VIRGINIA, INC. (NPI# 1649610445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649610445 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CARE OF WEST VIRGINIA, INC. |
| Other Organization Name | LUMBERPORT ELEMENTARY SCHOOL WELLNESS CENTER |
| Practice Address |
Chestnut & Lyndon Streets Lumberport WV 26386-0000 |
| Mailing Address |
Po Box 217 Rock Cave WV 26234-0217 |
| Practice Telephone | 3043267020 |
| Practice Fax Number | 3045845943 |
| Mailing Telephone | 3049246262 |
| Mailing Fax Number | 3049245460 |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2013-06-26 |
| Authorized Official Name | DORA L POTASNIK (CREDENTIALING) |
| Authorized Official Telephone | 3045872541 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMUNITY CARE OF WEST VIRGINIA, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
2287-3648 | WV | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | BUSINESS LICENSE | 2287-3648 | 01 |
| Other Name | Type Code |
|---|---|
| Lumberport Elementary School Wellness Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194339309 | Community Care of West Virginia, Inc. | Clinic/Center | 33 E Victoria St, Buckhannon, WV 26201-2671 | 2020-09-04 |
| 1063048189 | Community Care of West Virginia, Inc. | Clinic/Center | 34 N Kanawha St, Buckhannon, WV 26201-2714 | 2020-03-20 |
| 1538711452 | Community Care of West Virginia, Inc. | Clinic/Center | 481 Heavner Grove Rd, Buckhannon, WV 26201-4859 | 2019-07-11 |
| 1710539630 | Community Care of West Virginia, Inc. | Clinic/Center | 5078 Tallmansville Rd, Buckhannon, WV 26201-1687 | 2019-07-11 |
| 1871003178 | Community Care of West Virginia, Inc. | Clinic/Center | 228 Kanawha Avenue, Burnsville, WV 26335 | 2017-10-02 |
| 1053821363 | Community Care of West Virginia, Inc. | Clinic/Center | 55 Little Birch Rd, Sutton, WV 26601-9469 | 2017-10-02 |
| 1609386978 | Community Care of West Virginia, Inc. | Clinic/Center | 15300 Us Highway 33 W, Linn, WV 26384-9322 | 2017-10-02 |
| 1962912261 | Community Care of West Virginia, Inc. | Clinic/Center | 142 Flatwoods Corner Road, Flatwoods, WV 26621 | 2017-10-02 |
| 1811366248 | Community Care of West Virginia, Inc. | Clinic/Center | 501 Bomont Rd, Bomont, WV 25030-9666 | 2015-09-16 |
| 1043686553 | Community Care of West Virginia, Inc. | Clinic/Center | 358 Court Ave, Weston, WV 26452-2008 | 2015-08-19 |
| Street Address |
CHESTNUT & LYNDON STREETS |
| City | LUMBERPORT |
| State | WV |
| Zip Code | 26386-0000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114525037 | Tammy Joan Miller | Technician | 62 Davis St, Lumberport, WV 26386 | 2020-10-13 |
| 1225649155 | Marvin Ray Hilliard | Technician | 2492 Lumberport Rd, Lumberport, WV 26386 | 2020-08-13 |
| 1326034141 | Lumberport Pharmacy, Inc | Pharmacy | 308 Main Street, Lumberport, WV 26386 | 2005-09-27 |
| 1275149890 | Brenda Mcdaniel | Technician | 102 2nd St, Lumberport, WV 26386 | 2020-09-18 |
| 1144398819 | United Physicians Care Inc | Nurse Practitioner | 317 Main St, Lumberport, WV 26386-0398 | 2006-12-01 |
| 1831267343 | United Physician Care Inc | Clinical Medical Laboratory | 317 Main St, Lumberport, WV 26386-0398 | 2006-12-01 |
| 1861831323 | Community Care of West Virginia, Inc. | Clinic/Center | 314 Main St, Lumberport, WV 26386-8000 | 2013-06-18 |
| 1265734073 | Susan P Meredith | Pharmacist | 308 Main St, Lumberport, WV 26386-8000 | 2010-11-30 |
| 1477855302 | Carol Mckisic | Pharmacist | 308 Main St, Lumberport, WV 26386-8000 | 2010-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114525037 | Tammy Joan Miller | Technician | 62 Davis St, Lumberport, WV 26386 | 2020-10-13 |
| 1225649155 | Marvin Ray Hilliard | Technician | 2492 Lumberport Rd, Lumberport, WV 26386 | 2020-08-13 |
| 1326034141 | Lumberport Pharmacy, Inc | Pharmacy | 308 Main Street, Lumberport, WV 26386 | 2005-09-27 |
| 1275149890 | Brenda Mcdaniel | Technician | 102 2nd St, Lumberport, WV 26386 | 2020-09-18 |
| 1861831323 | Community Care of West Virginia, Inc. | Clinic/Center | 314 Main St, Lumberport, WV 26386-8000 | 2013-06-18 |
| 1265734073 | Susan P Meredith | Pharmacist | 308 Main St, Lumberport, WV 26386-8000 | 2010-11-30 |
| 1477855302 | Carol Mckisic | Pharmacist | 308 Main St, Lumberport, WV 26386-8000 | 2010-11-29 |
| 1144398819 | United Physicians Care Inc | Nurse Practitioner | 317 Main St, Lumberport, WV 26386-0398 | 2006-12-01 |
| 1831267343 | United Physician Care Inc | Clinical Medical Laboratory | 317 Main St, Lumberport, WV 26386-0398 | 2006-12-01 |
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861831323 | Community Care of West Virginia, Inc. | Clinic/Center | 314 Main St, Lumberport, WV 26386-8000 | 2013-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493499 | Camden On Gauley Medical Center Inc | Clinic/Center | 52 Florence Street, Ansted, WV 25812 | 2020-10-06 |
| 1194339309 | Community Care of West Virginia, Inc. | Clinic/Center | 33 E Victoria St, Buckhannon, WV 26201-2671 | 2020-09-04 |
| 1063048189 | Community Care of West Virginia, Inc. | Clinic/Center | 34 N Kanawha St, Buckhannon, WV 26201-2714 | 2020-03-20 |
| 1619503422 | Change Inc | Clinic/Center | 114 Taylor Ave, Weirton, WV 26062-4635 | 2020-03-13 |
| 1861023699 | Logan-mingo Area Mental Health, Inc | Clinic/Center | 2954 Buffalo Creek Road, Chattaroy, WV 25667 | 2020-01-30 |
| 1689220402 | New River Health Association, Inc. | Clinic/Center | 2 Greyhound Ln., Smithers, WV 25186 | 2019-08-16 |
| 1740836873 | Williamson Health & Wellness Center Inc | Clinic/Center | 5 Parkway Dr, Williamson, WV 25661-3428 | 2019-08-14 |
| 1699321729 | Williamson Health & Wellness Center Inc | Clinic/Center | 50 Panther Blvd, Williamson, WV 25661-7441 | 2019-08-14 |
| 1083260129 | Williamson Health & Wellness Center Inc | Clinic/Center | 300 Blue Devil Lane, Kermit, WV 25661 | 2019-08-14 |
| 1225684731 | Williamson Health & Wellness Center Inc | Clinic/Center | 1000 King Coal Hwy, Delbarton, WV 25670-9529 | 2019-08-12 |
| Find all providers with the same taxonomy | ||||
| City | LUMBERPORT |
| Zip Code | 26386 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.