Healthcare Provider Details

I. General information

NPI: 1194007518
Provider Name (Legal Business Name): CONTINIUMCARE OF WEBER CITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2011
Last Update Date: 01/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 CLONCE ST
WEBER CITY VA
24290-7269
US

IV. Provider business mailing address

377 CLONCE ST
WEBER CITY VA
24290-7269
US

V. Phone/Fax

Practice location:
  • Phone: 276-386-9444
  • Fax: 276-386-6113
Mailing address:
  • Phone: 276-386-9444
  • Fax: 276-386-6113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. THEODORE MATTHEW DUAY III
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CPA
Phone: 786-888-3310