Healthcare Provider Details
I. General information
NPI: 1235726548
Provider Name (Legal Business Name): ROBERT HINCHEE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/22/2020
Last Update Date: 01/04/2021
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
108 SMITH ST
WEIRTON WV
26062-4016
US
IV. Provider business mailing address
108 SMITH ST
WEIRTON WV
26062-4016
US
V. Phone/Fax
- Phone: 304-374-2073
- Fax:
- Phone: 304-374-2073
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 373H00000X |
| Taxonomy | Day Training/Habilitation Specialist |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: