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Organization

MOUNTAIN EMPIRE OLDER CITIZENS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERESA SHOOP (ASSOCIATE ACCOUNTANT)
(276) 523-4202
Entity
Organization

Contact information

Practice address
1501 3RD AVE E, BIG STONE GAP, VA 24219-3115
(276) 523-4202
(276) 523-4208
Mailing address
PO BOX 888, 1501 THIRD AVENUE EAST, BIG STONE GAP, VA 24219-0888
(276) 523-4202
(276) 523-4208

Taxonomy

Speciality
Code
Description
License number
State
251T00000X
PACE Provider Organization
253Z00000X
In Home Supportive Care Agency
Primary
343900000X
Non-emergency Medical Transport (VAN)
385H00000X
Respite Care

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1184807661
VA
05
1972534659
VA
Enumeration date
07/02/2015
Last updated
06/27/2022
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