MEDICARE: STONEWALL JACKSON MEMORIAL HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	300699	OTHER	WV	FEDERAL BLACK LUNG
2	WV22958A	OTHER	WV	HEALTH PLAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083617989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STONEWALL JACKSON MEMORIAL HOSPITAL

Provider Business Mailing Address
First Line	:	456 SUITE B MARKET PLACE MALL
Second Line	:
City	:	WESTON
State	:	WV
Zip	:	26452-6938
Country	:	US
Telephone Number	:	304-269-4556
Fax Number	:	304-269-4559

Provider Business Practice Location Address
First Line	:	456 SUITE B MARKET PLACE MALL
Second Line	:
City	:	WESTON
State	:	WV
Zip	:	26452-6938
Country	:	US
Telephone Number	:	304-269-4556
Fax Number	:	304-269-4559

Authorized Official
Title or Position	:	DIRECTOR OF EXTERNAL OPERATIONS
Name	:	MRS. M. JANE EISENBEIS
Credential	:	RN
Telephone Number	:	304-269-4556

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/21/2022

Similar Medicare Providers

1033546924 — STONEWALL HOME OXYGEN THERAPY, INC.
Practice Location Address:

456 MARKET PLACE MALL , SUITE A
WESTON, WV
26452-6938

Practice Phone: 304-269-0100
Practice Fax: 304-269-4559

1942156021 — LEONARD RILEY
Practice Location Address:

171 W 2ND ST
WESTON, WV
26452-1665

Practice Phone: 304-269-5738
Practice Fax:

1225062631 — DR. DAVID ALLEN ANDERSON DPM
Practice Location Address:

433 MAIN AVE
WESTON, WV
26452-2047

Practice Phone: 304-269-3445
Practice Fax: 304-269-5208

1689529000 — CARL W. WHITE II
Practice Location Address:

171 W 2ND ST
WESTON, WV
26452-1665

Practice Phone: 304-269-5738
Practice Fax:

1184513285 — ADAM RIDDLE RN
Practice Location Address:

15 PARK PL
WESTON, WV
26452-6952

Practice Phone: 304-517-5871
Practice Fax:

1851396527 — PAUL LATTIMER DC
Practice Location Address:

18 GARTON PLZ
WESTON, WV
26452-2129

Practice Phone: 304-269-4843
Practice Fax: 304-269-3522

Directions to “STONEWALL JACKSON MEMORIAL HOSPITAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.