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Contact Information

590 NORTH POPLAR FORK ROAD OPERATIONS LLC
590 POPLAR FORK RD
HURRICANE, WV25526-9434
 Phone: 304-757-7826
 Fax: 304-757-8861
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
Indicates primary specialty

NPI Profile & details for 590 NORTH POPLAR FORK ROAD OPERATIONS LLC

NPI # 1194909382
LBN Legal business name 590 NORTH POPLAR FORK ROAD OPERATIONS LLC
Authorized official MICHAEL BERG - (SECRETARY)
Entity Organization
Organization subpart 1 No
Enumeration date 12/24/2007
Last updated 10/06/2025 - About 8 months ago
Identifiers
WV License # 118
WV Medicaid 0002827000
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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