Brian McCormick

Individual provider Active NPI Home Health Aide · Letart, WV

NPI 1376396994 · NPPES record last updated Apr 11, 2024

Key facts

NPI
1376396994
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Aide 374U00000X
Practice address
5982 Tombleson Rd
Letart, WV 25253-9377
Phone
(740) 645-8717
NPI assigned
Apr 11, 2024
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
Home Health Aide
Group: 193400000X SINGLE SPECIALTY GROUP
374U00000X Yes

Addresses

Primary practice location

5982 Tombleson Rd
Letart, WV 25253-9377

Mailing address

5982 Tombleson Rd
Letart, WV 25253-9377

Other providers in Letart, WV

All providers in Letart, WV · Home Health Aide in West Virginia

Sources for this page

Verify at the official NPI Registry.