# AMARIS MEDICAL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013524057
- **Authorized official:** ANGEL L STOVER APRN (OWNER)
- **Authorized official phone:** (681) 207-7007

## Contact information

- **Practice address:** 76 LEWIS STREET, WHITESVILLE, WV 25209
- **Practice address phone:** (304) 896-0268
- **Practice address fax:** (304) 896-0289
- **Mailing address:** PO BOX 130, WHITESVILLE, WV 25209-0130
- **Mailing address phone:** (304) 896-0268
- **Mailing address fax:** (304) 896-0289

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 09/24/2020
- **Last updated:** 12/13/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 499198 | WV SECRETARY OF STATE | WV |