Healthcare Provider Details
I. General information
NPI: 1447920236
Provider Name (Legal Business Name): WVUHS HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/14/2021
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1952 NEW CREEK HWY
KEYSER WV
26726-7494
US
IV. Provider business mailing address
2673 DAVISSON RUN RD
CLARKSBURG WV
26301-6838
US
V. Phone/Fax
- Phone: 304-597-3366
- Fax: 304-597-1261
- Phone: 304-624-2424
- Fax: 304-622-9458
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICHOLAS
BARCELLONA
Title or Position: CFO
Credential:
Phone: 304-598-4655