Organization
MCCOY R.N.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITA DAWN MCCOY RN (OWNER)
(304) 475-2192
Entity
Organization
Contact information
Practice address
57 POLK ST, DELBARTON, WV 25670-1107
(304) 475-2192
(304) 475-3817
Mailing address
57 POLK ST, DELBARTON, WV 25670-1107
(304) 475-2192
(304) 475-3817
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
89109
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
89109
REGISTERED NURSE LICENSE
WV
Enumeration date
04/28/2017
Last updated
04/28/2017
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