Provider Demographics
NPI:1356491690
Name:VARNEY MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:VARNEY MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MCDEVITT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-426-8113
Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:VARNEY
Mailing Address - State:WV
Mailing Address - Zip Code:25696-0279
Mailing Address - Country:US
Mailing Address - Phone:304-426-8113
Mailing Address - Fax:304-426-8102
Practice Address - Street 1:RT 52 BOX279
Practice Address - Street 2:
Practice Address - City:VARNEY
Practice Address - State:WV
Practice Address - Zip Code:25696
Practice Address - Country:US
Practice Address - Phone:304-426-8113
Practice Address - Fax:304-426-8102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV513904261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV513904Medicare Oscar/Certification