| Organization Name: | CENTRAL WV MEDCORP, INC. |
| NPI Number: | 1275558017 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REBECCA JEAN HAMMER (CFO) |
| Mailing Address: | 11 N Locust St Buckhannon |
| State: | WV US |
| Postal Code: | 262012231 |
| Phone Number: | 3044721600 |
| Fax Number: | 3044726382 |
| NPI Enumeration Date: | 07/13/2006 |
| NPI Last Update Date: | 10/31/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |