Sandra L Griffith, PROGRAM DIRECTOR

Individual provider Active NPI Personal Care Attendant · Poca, WV

NPI 1124636832 · NPPES record last updated Jul 20, 2020

Key facts

NPI
1124636832
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
1611 Charleston Road
Poca, WV 25159
Phone
(304) 769-8077
NPI assigned
Jul 20, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Service Station, LLC Past
since Aug 2, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

1611 Charleston Road
Poca, WV 25159

Mailing address

PO Box 285
Alum Creek, WV 25003-0285
Phone (304) 906-0279

Other providers in Poca, WV

All providers in Poca, WV · Personal Care Attendant in West Virginia

Sources for this page

Verify at the official NPI Registry.