Healthcare Provider Details

I. General information

NPI: 1568620417
Provider Name (Legal Business Name): MARIETTA MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2008
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 FARSON ST STE 130
BELPRE OH
45714-1068
US

IV. Provider business mailing address

401 MATTHEW ST ATTN: PHARMACY
MARIETTA OH
45750-1635
US

V. Phone/Fax

Practice location:
  • Phone: 740-374-1583
  • Fax: 740-374-1604
Mailing address:
  • Phone: 740-374-1446
  • Fax: 740-568-5484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA MCGEE
Title or Position: PROVIDER ENROLLMENT SUPERVISOR
Credential:
Phone: 740-374-6090