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Contact Information

WISHING WELL NURSING HOME, INC.
1539 COUNTRY CLUB RD
FAIRMONT, WV26554-1306
 Phone: 304-366-8414
 Fax: 304-363-2384
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

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

NPI Profile & details for WISHING WELL NURSING HOME, INC.

NPI # 1316935703
LBN Legal business name WISHING WELL NURSING HOME, INC.
Authorized official CARLENE MOORE - (CONTROLLER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/10/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers
WV License # 62
WV Medicaid 0003887000
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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