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NPI Code Detail

MEDICARE: LOGAN WHITE

MEDICARE: LOGAN WHITE
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1376476952
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOGAN WHITE
Provider Business Mailing Address
First Line : PO BOX 20112
Second Line :
City : CHARLESTON
State : WV
Zip : 25362-1112
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1599 2ND AVE
Second Line :
City : CHARLESTON
State : WV
Zip : 25387-2514
Country : US
Telephone Number : 304-344-0586
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2026
Last Update Date : 06/04/2026

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Directions to “ LOGAN WHITE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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