Provider Demographics
NPI:1720072739
Name:WEST VIRGINIA HOME HEALTH SVCS INC
Entity Type:Organization
Organization Name:WEST VIRGINIA HOME HEALTH SVCS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-348-1203
Mailing Address - Street 1:1418 MACCORKLE AVE SW
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-1331
Mailing Address - Country:US
Mailing Address - Phone:304-348-1203
Mailing Address - Fax:304-348-1410
Practice Address - Street 1:1418 MACCORKLE AVE SW
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25303-1331
Practice Address - Country:US
Practice Address - Phone:304-348-1203
Practice Address - Fax:304-348-1410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV517115251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
3037138OtherCAREMARK THERAPEUTIC
7629053OtherAETNA
43466OtherCARELINK MEDICAID
WV0001254004Medicaid
214381OtherCARELINK
62308OtherCIGNA
550392395006OtherTRICARE
1020193OtherWORKERS COMPENSATION
483262OtherMAMSI LIFE & HEALTH
550392395006OtherTRICARE
=========01OtherBLUE CROSS/BLUE SHIELD