Provider Demographics
NPI:1144384421
Name:GENERATIONS R.C., INC.
Entity Type:Organization
Organization Name:GENERATIONS R.C., INC.
Other - Org Name:PHYS. CTR. OF SCOTT-TEAYS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE VP - BUSINESS OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELORIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:BENTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-473-1080
Mailing Address - Street 1:PO BOX 687
Mailing Address - Street 2:
Mailing Address - City:GREENUP
Mailing Address - State:KY
Mailing Address - Zip Code:41144-0687
Mailing Address - Country:US
Mailing Address - Phone:606-473-1080
Mailing Address - Fax:606-473-5875
Practice Address - Street 1:3705 TEAYS VALLEY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9645
Practice Address - Country:US
Practice Address - Phone:304-757-2500
Practice Address - Fax:304-757-2586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1707207OtherBLUE CROSS BLUE SHIELD
WV3810000-212Medicaid
CN7183OtherRAILROAD MEDICARE
WV=========OtherAETNA
WV=========OtherCIGNA
WV=========00OtherW COMP HURRICANE, WV
WV=========OtherACORDIA
CN7183OtherRAILROAD MEDICARE