Provider Demographics
NPI:1396804092
Name:HEALTHCARE OF VIRGINIA
Entity type:Organization
Organization Name:HEALTHCARE OF VIRGINIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:POPE
Authorized Official - Last Name:MCELWAIN
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE RN BIOPRACTION
Authorized Official - Phone:304-645-3881
Mailing Address - Street 1:103 MACKLE LN
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-1220
Mailing Address - Country:US
Mailing Address - Phone:304-645-3881
Mailing Address - Fax:304-645-3881
Practice Address - Street 1:ROUTE 219
Practice Address - Street 2:VALUE INN
Practice Address - City:COVINGTON
Practice Address - State:WV
Practice Address - Zip Code:24901
Practice Address - Country:US
Practice Address - Phone:540-747-5403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV00011697353140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric