Organization
MCDOWELL COUNTY COMMISSION ON AGING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LISA E SANDERSON (EXECUTIVE DIRECTOR)
(304) 436-6588
Entity
Organization
Contact information
Practice address
725 STEWART ST, WELCH, WV 24801-2125
(304) 436-6588
(304) 436-2006
Mailing address
725 STEWART ST, WELCH, WV 24801-2125
(304) 436-6588
(304) 436-2006
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
FE271147
WV
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134348253
MEDICAID WAIVER
WV
05
—
1316166432
—
WV
Enumeration date
03/20/2012
Last updated
03/20/2012
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