Provider Demographics
NPI:1346571353
Name:GENERATIONS R.C. INC.
Entity Type:Organization
Organization Name:GENERATIONS R.C. INC.
Other - Org Name:GENERATIONS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:TARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-743-4954
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WV
Mailing Address - Zip Code:25541-0219
Mailing Address - Country:US
Mailing Address - Phone:304-743-4954
Mailing Address - Fax:304-743-0291
Practice Address - Street 1:12510 WINFIELD ROAD
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:WV
Practice Address - Zip Code:25213
Practice Address - Country:US
Practice Address - Phone:304-586-4200
Practice Address - Fax:304-586-4500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-15
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810021204Medicaid
WV3810021204Medicaid