Provider Demographics
NPI:1851793152
Name:ELKINS REGIONAL CONVALESCENT CENTER INC. DBA ELKINS REHAB AND CARE CTR
Entity Type:Organization
Organization Name:ELKINS REGIONAL CONVALESCENT CENTER INC. DBA ELKINS REHAB AND CARE CTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-636-1391
Mailing Address - Street 1:1175 BEVERLY PIKE
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-9759
Mailing Address - Country:US
Mailing Address - Phone:304-636-1391
Mailing Address - Fax:304-636-1371
Practice Address - Street 1:1175 BEVERLY PIKE
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-9759
Practice Address - Country:US
Practice Address - Phone:304-636-1391
Practice Address - Fax:304-636-1371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-18
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV134261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV515025Medicare Oscar/Certification