MEDICARE: ALEDADE CARE SOLUTIONS OF WEST VIRGINIA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1326785189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALEDADE CARE SOLUTIONS OF WEST VIRGINIA INC

Provider Business Mailing Address
First Line	:	232 CAPITOL ST
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25301-2234
Country	:	US
Telephone Number	:	681-202-4474
Fax Number	:

Provider Business Practice Location Address
First Line	:	232 CAPITOL ST
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25301-2234
Country	:	US
Telephone Number	:	681-202-4474
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT KOCHER
Credential	:
Telephone Number	:	202-253-8654

Provider Enumeration Date	:	05/13/2022
Last Update Date	:	05/13/2022

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