Healthcare Provider Details

I. General information

NPI: 1285779322
Provider Name (Legal Business Name): BERKELEY COUNTY COMMITTEE ON AGING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 N HIGH ST
MARTINSBURG WV
25401-4419
US

IV. Provider business mailing address

217 N HIGH ST
MARTINSBURG WV
25401-4419
US

V. Phone/Fax

Practice location:
  • Phone: 304-263-8873
  • Fax: 304-263-6598
Mailing address:
  • Phone: 304-263-8873
  • Fax: 304-263-6598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number036969
License Number StateWV

VIII. Authorized Official

Name: AMY ORNDOFF
Title or Position: DIRECTOR
Credential:
Phone: 304-263-8873