Provider Demographics
NPI:1194007518
Name:CONTINIUMCARE OF WEBER CITY LLC
Entity Type:Organization
Organization Name:CONTINIUMCARE OF WEBER CITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:DUAY
Authorized Official - Suffix:III
Authorized Official - Credentials:CPA
Authorized Official - Phone:786-888-3310
Mailing Address - Street 1:377 CLONCE ST
Mailing Address - Street 2:
Mailing Address - City:WEBER CITY
Mailing Address - State:VA
Mailing Address - Zip Code:24290-7269
Mailing Address - Country:US
Mailing Address - Phone:276-386-9444
Mailing Address - Fax:276-386-6113
Practice Address - Street 1:377 CLONCE ST
Practice Address - Street 2:
Practice Address - City:WEBER CITY
Practice Address - State:VA
Practice Address - Zip Code:24290-7269
Practice Address - Country:US
Practice Address - Phone:276-386-9444
Practice Address - Fax:276-386-6113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-12
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA495208Medicare Oscar/Certification