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General NPI Number Information
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NPI Number | 1023158102
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Entity Type | Organization
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Legal Business Name | EAST MOUNTAIN HEALTH ADVANTAGE, INC.
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 92 E MAIN ST
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City | ROMNEY
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State | WV
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Zip | 26757-1840
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Country | US
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Telephone | 304-822-5144
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Fax |
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Provider Business Mailing Address
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Address Line | 190 CAMPUS BLVD
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City | WINCHESTER
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State | VA
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Zip | 22601-2872
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Country | US
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Telephone | 540-536-8031
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Fax | 540-540-8019
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Authorized Official
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Title or Position | SECRETARY-TREASURER
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Name | MR. CRAIG LEWIS
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Credential |
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Telephone | 540-536-8031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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