Healthcare Provider Details

I. General information

NPI: 1386907855
Provider Name (Legal Business Name): WEST VIRGINIA NURSING NETWORK INFUSION SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 06/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600-B PRESTIGE PARK SUITE 5
HURRICANE WV
25526
US

IV. Provider business mailing address

600-B PRESTIGE PARK SUITE 5
HURRICANE WV
25526
US

V. Phone/Fax

Practice location:
  • Phone: 304-542-1968
  • Fax: 304-205-0518
Mailing address:
  • Phone: 304-542-1968
  • Fax: 304-205-0518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number StateWV

VIII. Authorized Official

Name: MRS. LAURA JILL HOPKINS
Title or Position: CEO/OWNER
Credential:
Phone: 304-542-1968