Healthcare Provider Details

I. General information

NPI: 1255371993
Provider Name (Legal Business Name): WVVA HEALTH CARE ALLIANCE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 04/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 POCAHONTAS TRL
WHITE SULPHUR SPRINGS WV
24986-5026
US

IV. Provider business mailing address

PO BOX 457 200 POCAHONTAS TRIAL
WHITE SULPHUR SPRINGS WV
24986-0457
US

V. Phone/Fax

Practice location:
  • Phone: 304-536-5030
  • Fax: 304-536-5051
Mailing address:
  • Phone: 304-536-5030
  • Fax: 304-536-5051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBIN Y DRUMMOND
Title or Position: VP RCM
Credential:
Phone: 304-536-5030