Healthcare Provider Details

I. General information

NPI: 1861443210
Provider Name (Legal Business Name): NORTHERN WV HOME HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

549 CENTER AVE
ROMNEY WV
26757-1352
US

IV. Provider business mailing address

549 CENTER AVE
ROMNEY WV
26757-1352
US

V. Phone/Fax

Practice location:
  • Phone: 304-822-5144
  • Fax: 304-822-5529
Mailing address:
  • Phone: 304-822-5144
  • Fax: 304-822-5529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number69
License Number StateWV

VIII. Authorized Official

Name: MR. HAROLD A MCBEE
Title or Position: OWNER
Credential:
Phone: 410-643-3393