Provider Demographics
NPI:1760181846
Name:SARTIN, MAHALA
Entity Type:Individual
Prefix:
First Name:MAHALA
Middle Name:
Last Name:SARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3460 CRITES MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:ERBACON
Mailing Address - State:WV
Mailing Address - Zip Code:26203-9741
Mailing Address - Country:US
Mailing Address - Phone:304-618-2911
Mailing Address - Fax:
Practice Address - Street 1:1401 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:KENOVA
Practice Address - State:WV
Practice Address - Zip Code:25530-1235
Practice Address - Country:US
Practice Address - Phone:304-453-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant