Organization
CARRUTH CENTER-SSC
Active
Organization
CARRUTH CENTER-SSC
Active
Parent organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Authorized official
ANDREA RUMBLE (PROVIDER ENROLLMENT SPECIALISTQ)
(304) 293-5033
Entity
Organization
Contact information
Practice address
700 COLLEGE AVENUE, 3RD FLOOR, MORGANTOWN, WV 26506-6422
(304) 293-4431
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 293-7401
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
08/24/2011
Last updated
08/24/2011
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