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NPI Code Detail

MEDICARE: EAGLE POINTE, INC

MEDICARE: EAGLE POINTE, INC
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
1314000000XSkilled Nursing Facility54WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21213110001OTHERWADMERC

General Provider Information

NPI Number : 1518954908
Entity Type Code : Organization
Provider Name (Legal Business Name) : EAGLE POINTE, INC
Provider Business Mailing Address
First Line : 1600 27TH ST
Second Line :
City : PARKERSBURG
State : WV
Zip : 26101-2815
Country : US
Telephone Number : 304-485-6476
Fax Number : 304-485-1306
Provider Business Practice Location Address
First Line : 1600 27TH ST
Second Line :
City : PARKERSBURG
State : WV
Zip : 26101-2815
Country : US
Telephone Number : 304-485-6476
Fax Number : 304-485-1306
Authorized Official
Title or Position : CEO
Name : MR. JAMES G BURKHART II
Credential :
Telephone Number : 317-788-2500
Provider Enumeration Date : 09/30/2005
Last Update Date : 08/22/2020

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Directions to “EAGLE POINTE, INC ” Practice Location

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