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General NPI Number Information
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NPI Number | 1386837219
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Entity Type | Organization
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Legal Business Name | NORTHERN WV HOME HEALTH LLC
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 08/23/2007
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Provider Practice Location Address
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Address Line | 690 S MINERAL ST
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City | KEYSER
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State | WV
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Zip | 26726-2823
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Country | US
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Telephone | 304-788-1285
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Fax | 304-788-2194
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Provider Business Mailing Address
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Address Line | 690 S MINERAL ST
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City | KEYSER
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State | WV
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Zip | 26726-2823
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Country | US
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Telephone | 304-788-1285
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Fax | 304-788-2194
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. HEATHER WINEGARDNER
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Credential | RN
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Telephone | 304-788-1285
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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 | 1007-3456
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License Number State | WV
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