Healthcare Provider Details

I. General information

NPI: 1346571353
Provider Name (Legal Business Name): GENERATIONS R.C. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2010
Last Update Date: 11/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12510 WINFIELD ROAD
WINFIELD WV
25213
US

IV. Provider business mailing address

PO BOX 219
MILTON WV
25541-0219
US

V. Phone/Fax

Practice location:
  • Phone: 304-586-4200
  • Fax: 304-586-4500
Mailing address:
  • Phone: 304-743-4954
  • Fax: 304-743-0291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. BRENDA LYNN TARR
Title or Position: CFO
Credential:
Phone: 304-743-4954