Healthcare Provider Details

I. General information

NPI: 1881665750
Provider Name (Legal Business Name): MOUNTAIN VIEW REGIONAL MEDICAL CENTER HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 W MAIN ST
WISE VA
24293-6904
US

IV. Provider business mailing address

PO BOX 440
NORTON VA
24273-0440
US

V. Phone/Fax

Practice location:
  • Phone: 276-679-9130
  • Fax: 276-328-4360
Mailing address:
  • Phone: 276-679-9130
  • Fax: 276-328-4360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateVA

VIII. Authorized Official

Name: TIMOTHY PARRY
Title or Position: SR. VP AND GENERAL COUNSEL
Credential: ESQ
Phone: 239-598-3176