Organization
INDIVIDUAL HOME CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK E. ROMANO (PRESIDENT)
(304) 872-2189
Entity
Organization
Contact information
Practice address
ROUTE 19, 77 PUDDY RUN ROAD, SUMMERSVILLE, WV 26651-0455
(304) 872-2189
(304) 872-2189
Mailing address
PO BOX 455, SUMMERSVILLE, WV 26651-0455
(304) 872-2189
(304) 872-2189
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
032828
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0031070000
—
WV
Enumeration date
03/28/2007
Last updated
08/22/2020
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