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General NPI Number Information
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NPI Number | 1174523187
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Entity Type | Organization
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Legal Business Name | OHIO VALLEY NURSING HOME INC
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Dates
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Enumeration Date | 08/01/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 222 NICOLETT RD
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City | PARKERSBURG
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State | WV
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Zip | 26104-7282
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Country | US
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Telephone | 304-485-5137
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Fax | 304-485-5184
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Provider Business Mailing Address
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Address Line | 222 NICOLETT RD
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City | PARKERSBURG
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State | WV
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Zip | 26104-7282
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Country | US
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Telephone | 304-485-5137
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Fax | 304-485-5184
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. MICHAEL A MILLER
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Credential |
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Telephone | 304-485-5137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 159
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License Number State | WV
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