Organization
MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS INC
Active
Other names
MVA Optical Services
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY L VANDERGRIFT (PRESIDENT)
(304) 366-0700
Entity
Organization
Contact information
Practice address
1322 LOCUST AVE, FAIRMONT, WV 26554-1436
(304) 366-0700
(304) 366-9529
Mailing address
1322 LOCUST AVE, PO BOX 1112, FAIRMONT, WV 26554-1436
(304) 366-0700
(304) 366-9529
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035167006
—
WV
01
—
407540248
RR MEDICARE
WV
01
—
485041
NATIONAL CAPITAL PPO
WV
Enumeration date
09/06/2006
Last updated
08/11/2011
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