Basic Information
| Provider Information | |||||||||
| NPI: | 1194007518 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CONTINIUMCARE OF WEBER CITY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 377 CLONCE ST | ||||||||
| Address2: | |||||||||
| City: | WEBER CITY | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242907269 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2763869444 | ||||||||
| FaxNumber: | 2763866113 | ||||||||
| Practice Location | |||||||||
| Address1: | 377 CLONCE ST | ||||||||
| Address2: | |||||||||
| City: | WEBER CITY | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242907269 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2763869444 | ||||||||
| FaxNumber: | 2763866113 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2011 | ||||||||
| LastUpdateDate: | 01/05/2012 | ||||||||
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| AuthorizedOfficialLastName: | DUAY | ||||||||
| AuthorizedOfficialFirstName: | THEODORE | ||||||||
| AuthorizedOfficialMiddleName: | MATTHEW | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 7868883310 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | III | ||||||||
| AuthorizedOfficialCredential: | CPA | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.