Healthcare Provider Details

I. General information

NPI: 1760664635
Provider Name (Legal Business Name): TUCKER COUNTY SENIOR CITIZENS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 3RD ST
PARSONS WV
26287-1041
US

IV. Provider business mailing address

206 3RD ST
PARSONS WV
26287-1041
US

V. Phone/Fax

Practice location:
  • Phone: 304-478-2423
  • Fax: 304-478-4828
Mailing address:
  • Phone: 304-478-2423
  • Fax: 304-478-4828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARY A. SMITH
Title or Position: FINANCIAL OFFICER
Credential:
Phone: 304-478-2423