Provider Demographics
NPI:1841210101
Name:ARRHYTHMIA TREATMENT ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:ARRHYTHMIA TREATMENT ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCCOWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-720-8822
Mailing Address - Street 1:505 CAPITOL ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-1220
Mailing Address - Country:US
Mailing Address - Phone:304-720-8822
Mailing Address - Fax:304-720-8826
Practice Address - Street 1:505 CAPITOL ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1220
Practice Address - Country:US
Practice Address - Phone:304-720-8822
Practice Address - Fax:304-720-8826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810002838Medicaid
WV3810002838Medicaid