Provider Demographics
NPI:1851081236
Name:HAMPSHIRE COUNTY COMMITTEE ON AGING
Entity Type:Organization
Organization Name:HAMPSHIRE COUNTY COMMITTEE ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-822-4097
Mailing Address - Street 1:PO BOX 41
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-0041
Mailing Address - Country:US
Mailing Address - Phone:304-822-4097
Mailing Address - Fax:
Practice Address - Street 1:24781 NORTHWESTERN TURNPIKE
Practice Address - Street 2:
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757-2675
Practice Address - Country:US
Practice Address - Phone:304-822-4097
Practice Address - Fax:304-822-7322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-10
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1023236361Medicaid
WV1275665622Medicaid
WV1841418159Medicaid