Organization
WVDHHR JOHN MANCHIN SR HEALTH CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL D MERRILL NHA (CEO ADMINISTRATOR)
(304) 363-2500
Entity
Organization
Contact information
Practice address
401 GUFFEY STREET, FAIRMONT, WV 26554
(304) 363-2500
(304) 363-0263
Mailing address
401 GUFFEY STREET, FAIRMONT, WV 26554
(304) 363-2500
(304) 363-0263
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C13880
MEDICARE RAILROAD
—
Enumeration date
08/01/2006
Last updated
12/04/2007
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