Healthcare Provider Details
I. General information
NPI: 1740298355
Provider Name (Legal Business Name): PANHANDLE SUPPORT SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/03/2006
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6441 FARMDALE RD
BARBOURSVILLE WV
25504-1305
US
IV. Provider business mailing address
2227 CHAPLINE ST
WHEELING WV
26003-3842
US
V. Phone/Fax
- Phone: 304-453-4992
- Fax: 304-453-5574
- Phone: 304-242-9145
- Fax: 304-242-6965
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EVAN
BRADLEY
WORRELL
Title or Position: EXECUTIVE DIRECTOR OF OPERATIONS
Credential:
Phone: 304-242-9145