Healthcare Provider Details

I. General information

NPI: 1164799847
Provider Name (Legal Business Name): CENTRAL WEST VIRGINIA AGING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2011
Last Update Date: 11/04/2020
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 N SPRING ST
BUCKHANNON WV
26201-2720
US

IV. Provider business mailing address

8 N SPRING ST PO BOX 186
BUCKHANNON WV
26201-2720
US

V. Phone/Fax

Practice location:
  • Phone: 304-472-0395
  • Fax: 304-472-4673
Mailing address:
  • Phone: 304-472-0395
  • Fax: 304-472-4673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateWV

VIII. Authorized Official

Name: MRS. EVELYN POST
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 304-472-0395