|
|
Certified Provider Details:
| PROVIDER NUMBER: |
490093 |
| AGENCY NAME: |
WVU Hospital Care Management Dept. |
| CONTACT NAME: |
Juleen Zimmer |
| ADDRESS: |
Po Box 8237 |
| CITY: |
Morgantown |
| STATE: |
WV |
| ZIP: |
26506 |
| PHONE: |
(304) 598-4183 |
| WEB SITE: |
|
| EMAIL ADDRESS: |
|
| BSW/MSW NAME: |
Juleen Zimmer |
| DUE TO RECERTIFY DATE: |
7/1/2011 |
| COMMENTS: |
|
|
