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General NPI Number Information
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NPI Number | 1508086703
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Entity Type | Organization
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Legal Business Name | WV VETERANS NURSING FACILITY
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 05/10/2019
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Provider Practice Location Address
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Address Line | ONE FREEDOM WAY
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City | CLARKSBURG
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State | WV
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Zip | 26301
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Country | US
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Telephone | 304-626-1600
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Fax | 304-626-1605
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Provider Business Mailing Address
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Address Line | ONE FREEDOM WAY
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City | CLARKSBURG
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State | WV
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Zip | 26301
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Country | US
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Telephone | 304-626-1600
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Fax | 304-626-1605
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Authorized Official
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Title or Position | ACTING ADMINISTRATOR
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Name | MS. SHERRI ANN REED
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Credential | LNHA
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Telephone | 304-626-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | #182
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License Number State | WV
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