Provider Demographics
NPI:1255371993
Name:WVVA HEALTH CARE ALLIANCE PC
Entity type:Organization
Organization Name:WVVA HEALTH CARE ALLIANCE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP RCM
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:Y
Authorized Official - Last Name:DRUMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-536-5030
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:200 POCAHONTAS TRIAL
Mailing Address - City:WHITE SULPHUR SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:24986-0457
Mailing Address - Country:US
Mailing Address - Phone:304-536-5030
Mailing Address - Fax:304-536-5051
Practice Address - Street 1:200 POCAHONTAS TRL
Practice Address - Street 2:
Practice Address - City:WHITE SULPHUR SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:24986-5026
Practice Address - Country:US
Practice Address - Phone:304-536-5030
Practice Address - Fax:304-536-5051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0010494000Medicaid
VAC05310Medicare PIN
WV0010494000Medicaid
VAFVS026Medicare PIN
WV9289161Medicare PIN