Medicaid Waiver

LBN: Mountain Cap Of W
Medicaid Waiver is an health care organization with primary practice located at 105 Jerry Burton Dr , Sutton WV 26601-9767. The organization recently has only one registered license in Agencies / Home Health, which is considered as the primary health care specialty. Mountain Cap Of W can be contacted via phone (304) 765-7738, or through Walker, Lori A via phone (304) 765-7738.

Contact Information

Primary practice address
105 Jerry Burton Dr Sutton WV 26601-9767
Phone: (304) 765-7738
Fax: (304) 765-7308
Website:
Map and Directions
Authorized official contact:
Name: Walker, Lori A
Phone: (304) 765-7738

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X

Profile Details

NPI number 1639292873
LBN Legal business name Mountain Cap Of W
DBA Doing business as Medicaid Waiver
Authorized official Walker, Lori A
Entity Organization
Organization subpart 1 No
Enumeration date Apr 10th, 2007
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639292873 NPPES
West Virginia MEDICAID 0031226000

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