Rick Poling

Individual provider Active NPI Personal Care Attendant · Grantsville, WV

NPI 1407258148 · NPPES record last updated Sep 25, 2014

Key facts

NPI
1407258148
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
License
10359463 (WV)
Practice address
105 Market St.
Grantsville, WV 26147
Phone
(304) 354-7017
Fax
(304) 354-6859
NPI assigned
Sep 25, 2014
Sex
Male
Sole proprietor
No

Organizations & group practices 3

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

State licenses

LicenseStateTypeSpecialty
10359463WVMDPersonal Care Attendant

Practice roles

OrganizationSpecialtyStatusNew patients
Calhoun County Committee on Aging, Inc. Past
since Jan 3, 2021
Accepting new patients
Calhoun County Committee on Aging Past Accepting new patients
Calhoun County Committee on Aging Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X 10359463 WV Yes

Addresses

Primary practice location

105 Market St.
Grantsville, WV 26147

Mailing address

PO Box 619
Grantsville, WV 26147-0619
Phone (304) 354-7017

Other identifiers

IdentifierTypeStateIssuer
0030566000MedicaidWV
0030566001MedicaidWV

Other providers in Grantsville, WV

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

Sources for this page

Verify at the official NPI Registry.