Healthcare Provider Details

I. General information

NPI: 1497067417
Provider Name (Legal Business Name): HOMETOWN CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2010
Last Update Date: 02/16/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 S. CRIM AVE
BELINGTON WV
26250-9424
US

IV. Provider business mailing address

606 CRIM AVE
BELINGTON WV
26250-9424
US

V. Phone/Fax

Practice location:
  • Phone: 304-823-0223
  • Fax: 304-823-0224
Mailing address:
  • Phone: 304-823-0223
  • Fax: 304-823-0224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number22368317
License Number StateWV

VIII. Authorized Official

Name: MS. CAROLYN A PHILLIPS
Title or Position: DIRECTOR
Credential:
Phone: 304-823-0223