Provider Demographics
NPI:1801006200
Name:WVVA HEALTH CARE ALLIANCE, PC
Entity Type:Organization
Organization Name:WVVA HEALTH CARE ALLIANCE, PC
Other - Org Name:WVVA SLEEP LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCCORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-536-5030
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:200 POCAHONTAS TRAIL
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:24986-0457
Mailing Address - Country:US
Mailing Address - Phone:304-536-5030
Mailing Address - Fax:304-536-5051
Practice Address - Street 1:3738 DAVID STUART ROAD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-9463
Practice Address - Country:US
Practice Address - Phone:304-793-2274
Practice Address - Fax:304-793-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9289161Medicare PIN