Provider Demographics
NPI:1225324288
Name:DIGNITY HOSPICE OF SOUTHERN WEST VIRGINIA INC.
Entity Type:Organization
Organization Name:DIGNITY HOSPICE OF SOUTHERN WEST VIRGINIA INC.
Other - Org Name:DIGNITY MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTING DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:GORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-855-4764
Mailing Address - Street 1:PO BOX 4304
Mailing Address - Street 2:557 MAIN STREET
Mailing Address - City:CHAPMANVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25508
Mailing Address - Country:US
Mailing Address - Phone:304-855-4764
Mailing Address - Fax:304-855-7407
Practice Address - Street 1:557 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CHAPMANVILLE
Practice Address - State:WV
Practice Address - Zip Code:25508-4304
Practice Address - Country:US
Practice Address - Phone:304-855-4764
Practice Address - Fax:304-855-7407
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIGNITY HOSPICE OF SOUTHERN WEST VIRGINIA INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-28
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies