Provider Demographics
NPI:1245228071
Name:PRIDE IN LOGAN CO INC
Entity Type:Organization
Organization Name:PRIDE IN LOGAN CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:B
Authorized Official - Last Name:CURRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-752-0994
Mailing Address - Street 1:PO BOX 1346
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:WV
Mailing Address - Zip Code:25601-1346
Mailing Address - Country:US
Mailing Address - Phone:304-752-0994
Mailing Address - Fax:304-752-1047
Practice Address - Street 1:699 STRATTON ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601-4020
Practice Address - Country:US
Practice Address - Phone:304-752-0994
Practice Address - Fax:304-752-1047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0030732001Medicaid
WV0030732000Medicaid
WV0030732002Medicaid