Healthcare Provider Details

I. General information

NPI: 1144205170
Provider Name (Legal Business Name): NORTHERN WV HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2005
Last Update Date: 07/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 WAR MEMORIAL DR
BERKELEY SPRINGS WV
25411-1743
US

IV. Provider business mailing address

333 W CORK ST SUITE 135
WINCHESTER VA
22601-3870
US

V. Phone/Fax

Practice location:
  • Phone: 304-788-1285
  • Fax: 304-788-2194
Mailing address:
  • Phone: 540-536-5200
  • Fax: 540-536-5202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. DAVID PAUL APPLEWOOD
Title or Position: VP &CFO
Credential: MBA
Phone: 304-258-6523