Provider Demographics
NPI:1790176840
Name:WEST VIRGINIA HOME HEALTH LLC
Entity Type:Organization
Organization Name:WEST VIRGINIA HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:SALE
Authorized Official - Last Name:COREY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-431-3202
Mailing Address - Street 1:300 FOXCROFT AVE
Mailing Address - Street 2:SUITE 100B-6
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-5341
Mailing Address - Country:US
Mailing Address - Phone:703-431-3202
Mailing Address - Fax:540-301-0751
Practice Address - Street 1:300 FOXCROFT AVE
Practice Address - Street 2:SUITE 100B-6
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-5341
Practice Address - Country:US
Practice Address - Phone:703-431-3202
Practice Address - Fax:540-301-0751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health