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NPI Code Detail

MEDICARE: FAYETTE COMMUNITY HEALTH CARE

MEDICARE: FAYETTE COMMUNITY HEALTH CARE
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
1314000000XSkilled Nursing Facility129WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720081615
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAYETTE COMMUNITY HEALTH CARE
Provider Business Mailing Address
First Line : 422 23RD ST
Second Line :
City : OAK HILL
State : WV
Zip : 25901-2830
Country : US
Telephone Number : 304-465-1903
Fax Number : 304-949-3807
Provider Business Practice Location Address
First Line : 422 23RD ST
Second Line :
City : OAK HILL
State : WV
Zip : 25901-2830
Country : US
Telephone Number : 304-465-1903
Fax Number : 304-949-3807
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. CALVIN L SUTPHIN II
Credential : NHA
Telephone Number : 304-465-1903
Provider Enumeration Date : 05/24/2005
Last Update Date : 08/22/2020

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Directions to “FAYETTE COMMUNITY HEALTH CARE ” Practice Location

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