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NPI Code Detail

MEDICARE: PUTNAM COUNTY AGING PROGRAM, INC

MEDICARE: PUTNAM COUNTY AGING PROGRAM, 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
1251B00000XCase Management Agency

Other Identifiers

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

General Provider Information

NPI Number : 1700285764
Entity Type Code : Organization
Provider Name (Legal Business Name) : PUTNAM COUNTY AGING PROGRAM, INC
Provider Business Mailing Address
First Line : 2558 WINFIELD RD
Second Line :
City : SAINT ALBANS
State : WV
Zip : 25177-7804
Country : US
Telephone Number : 304-755-2385
Fax Number :
Provider Business Practice Location Address
First Line : 2558 WINFIELD RD
Second Line :
City : SAINT ALBANS
State : WV
Zip : 25177-7804
Country : US
Telephone Number : 304-755-2385
Fax Number :
Authorized Official
Title or Position : FISCAL OFFICER
Name : DEBRA DOSS
Credential :
Telephone Number : 304-755-2385
Provider Enumeration Date : 08/15/2014
Last Update Date : 08/15/2014

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Directions to “PUTNAM COUNTY AGING PROGRAM, INC ” Practice Location

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