Basic Information
| Provider Information | |||||||||
| NPI: | 1821110099 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ENDURACARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 214 LAUREL DR | ||||||||
| Address2: | |||||||||
| City: | CROSS JUNCTION | ||||||||
| State: | VA | ||||||||
| PostalCode: | 226252551 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 456 AUTUMN ACRES | ||||||||
| Address2: | |||||||||
| City: | BERKELEY SPRINGS | ||||||||
| State: | WV | ||||||||
| PostalCode: | 25411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042583673 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | BUCHHOLZ | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICAL THERAPIST | ||||||||
| AuthorizedOfficialTelephone: | 3042583673 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.