Healthcare Provider Details

I. General information

NPI: 1801915335
Provider Name (Legal Business Name): POCAHONTAS COUNTY SENIOR CITIZENS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

821 3RD AVE
MARLINTON WV
24954-1015
US

IV. Provider business mailing address

821 THIRD AVENUE
MARLINTON WV
24954
US

V. Phone/Fax

Practice location:
  • Phone: 304-799-6337
  • Fax:
Mailing address:
  • Phone: 304-799-6337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateWV

VIII. Authorized Official

Name: MRS. SHARON SHARP
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 304-799-6337