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Contact Information

GLENVILLE STATE COLLEGE
200 HIGH ST
GLENVILLE, WV26351-1200
 Phone: 972-367-4845
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

207RS0010X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for GLENVILLE STATE COLLEGE

NPI Number 1043850191
LBN Legal business name GLENVILLE STATE COLLEGE
Authorized official MOUZON BASS - (ADMINISTRATOR/AGENT)
Entity Organization
Organization subpart 1 No
Enumeration date 01/07/2020
Last updated 01/07/2020 - About 6 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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