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General NPI Number Information
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NPI Number | 1730262668
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Entity Type | Organization
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Legal Business Name | SNOWSHOE MOUNTAIN INC.
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10 SNOWSHOE DR.
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City | SNOWSHOE
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State | WV
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Zip | 26209
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Country | US
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Telephone | 304-572-5694
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Fax |
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Provider Business Mailing Address
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Address Line | 10 SNOWSHOE DR.
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City | SNOWSHOE
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State | WV
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Zip | 26209
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Country | US
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Telephone | 304-572-5694
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Fax |
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Authorized Official
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Title or Position | ASSISTANT DIRECTOR
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Name | MR. HANS JURGEN WHITE
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Credential | PA
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Telephone | 304-572-5694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 976331
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License Number State | WV
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