Charles Michael Crow

Individual provider Active NPI Personal Care Attendant · Glen Easton, WV

NPI 1033701420 · NPPES record last updated Feb 7, 2021

Key facts

NPI
1033701420
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
10098 Fork Ridge Rd
Glen Easton, WV 26039-1420
Phone
(304) 845-5719
NPI assigned
Feb 7, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

10098 Fork Ridge Rd
Glen Easton, WV 26039-1420

Mailing address

10098 Fork Ridge Rd
Glen Easton, WV 26039-1420
Phone (304) 845-5719

Other providers in Glen Easton, WV

All providers in Glen Easton, WV · Personal Care Attendant in West Virginia

Sources for this page

Verify at the official NPI Registry.