Dignity Hospice of Southern West Virginia Inc.

Organization Active NPI Durable Medical Equipment & Medical Supplies · Chapmanville, WV

NPI 1225324288 · NPPES record last updated Jul 15, 2014

Key facts

NPI
1225324288
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
DIGNITY HOSPICE OF SOUTHERN WEST VIRGINIA INC.
Practice address
557 Main Street
Chapmanville, WV 25508-4304
Phone
(304) 855-4764
Fax
(304) 855-7407
NPI assigned
Jun 28, 2011
Organization subpart
Yes
Parent organization (as reported)
DIGNITY HOSPICE OF SOUTHERN WEST VIRGINIA INC.

Authorized official

Name
Mrs. Susan P Gore
Title
Accounting Director
Phone
(304) 855-4764

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WV

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20141117001526 WV Part B Supplier - Mass Immunization (Roster Biller Only) 3779686118 Practice locations: Chapmanville, WV

National Provider Directory

Part of
Dignity Hospice of Southern

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Yes

Addresses

Primary practice location

557 Main Street
Chapmanville, WV 25508-4304

Mailing address

PO Box 4304
557 Main Street
Chapmanville, WV 25508
Phone (304) 855-4764

Other names

  • Dignity Medical Equipment Doing business as

Other providers in Chapmanville, WV

All providers in Chapmanville, WV · Durable Medical Equipment & Medical Supplies in West Virginia

Sources for this page

Verify at the official NPI Registry.