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NPI Code Detail

MEDICARE: STONERISE INTEGRITY CARE LLC

MEDICARE: STONERISE INTEGRITY CARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1194186585
Entity Type Code : Organization
Provider Name (Legal Business Name) : STONERISE INTEGRITY CARE LLC
Provider Business Mailing Address
First Line : 700 CHAPPELL RD
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-2704
Country : US
Telephone Number : 304-343-1950
Fax Number : 304-343-1947
Provider Business Practice Location Address
First Line : 700 CHAPPELL RD
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-2704
Country : US
Telephone Number : 304-343-1950
Fax Number : 304-343-1947
Authorized Official
Title or Position : MANAGER
Name : MR. LAWRENCE A PACK
Credential :
Telephone Number : 304-343-1950
Provider Enumeration Date : 03/11/2016
Last Update Date : 05/10/2016

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Directions to “STONERISE INTEGRITY CARE LLC ” Practice Location

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