Organization
MOUNTAIN EMPIRE OLDER CITIZENS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL K PEASE (EXECUTIVE DIRECTOR)
(276) 523-4202
Entity
Organization
Contact information
Practice address
1501 THIRD AVENUE EAST, BIG STONE GAP, VA 24219-3114
(276) 523-4202
(276) 523-4208
Mailing address
1520 3RD AVE E, P. O. BOX 888, BIG STONE GAP, VA 24219-3114
(276) 523-4202
(276) 523-4208
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
VA
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008700192
—
VA
05
—
008730857
—
VA
05
—
008740259
—
VA
05
—
008770042
—
VA
05
—
009105077
—
VA
05
—
010179238
—
VA
Enumeration date
07/05/2006
Last updated
07/21/2022
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