Organization
PRIMARY CARE AT HOME OF WEST VIRGINIA, LLC
Active
Other names
Primary Care at Home of Charleston
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD D. STELLY (PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
414 GREENWAY AVE STE 201, CHARLESTON, WV 25309-1475
(304) 356-1356
(304) 885-7475
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/12/2017
Last updated
09/12/2017
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