Provider Demographics
NPI:1861443210
Name:NORTHERN WV HOME HEALTH, LLC
Entity Type:Organization
Organization Name:NORTHERN WV HOME HEALTH, LLC
Other - Org Name:HAMPSHIRE MEMORIAL HOSPITAL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCBEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-643-3393
Mailing Address - Street 1:549 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:ROMNEY
Mailing Address - State:WV
Mailing Address - Zip Code:26757-1352
Mailing Address - Country:US
Mailing Address - Phone:304-822-5144
Mailing Address - Fax:304-822-5529
Practice Address - Street 1:549 CENTER AVE
Practice Address - Street 2:
Practice Address - City:ROMNEY
Practice Address - State:WV
Practice Address - Zip Code:26757-1352
Practice Address - Country:US
Practice Address - Phone:304-822-5144
Practice Address - Fax:304-822-5529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV69251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0001781002Medicaid
WV517073Medicare ID - Type Unspecified