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NPI Code Detail

MEDICARE: JAMES BENNETT

MEDICARE: JAMES BENNETT
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1578164992
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES BENNETT
Provider Business Mailing Address
First Line : 86 SELGOLD HL
Second Line :
City : MAYSVILLE
State : WV
Zip : 26833-8664
Country : US
Telephone Number : 304-749-7602
Fax Number :
Provider Business Practice Location Address
First Line : 1408 HARRISON AVE
Second Line :
City : ELKINS
State : WV
Zip : 26241-3325
Country : US
Telephone Number : 304-636-4390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2020
Last Update Date : 11/03/2020

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Directions to “ JAMES BENNETT ” Practice Location

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