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General NPI Number Information
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NPI Number | 1225486764
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Entity Type | Organization
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Legal Business Name | MASON COUNTY ACTION GROUP, INC.
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Dates
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Enumeration Date | 05/25/2016
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Last Update Date | 05/25/2016
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Provider Practice Location Address
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Address Line | 101 2ND ST
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City | POINT PLEASANT
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State | WV
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Zip | 25550-1012
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Country | US
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Telephone | 304-675-2369
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Fax | 304-675-2069
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Provider Business Mailing Address
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Address Line | 101 2ND ST
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City | POINT PLEASANT
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State | WV
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Zip | 25550-1012
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Country | US
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Telephone | 304-675-2369
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Fax | 304-675-2069
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Authorized Official
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Title or Position | FISCAL OFFICER
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Name | BONNIE NIBERT
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Credential |
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Telephone | 304-675-2369
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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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