Healthcare Provider Details

I. General information

NPI: 1851949465
Provider Name (Legal Business Name): WHEELING HOSPITAL AMBULATORY SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2019
Last Update Date: 08/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 STATE ROUTE 7
BRIDGEPORT OH
43912-1642
US

IV. Provider business mailing address

1 MEDICAL PARK BUSINESS OFFICE - NTTC
WHEELING WV
26003-6379
US

V. Phone/Fax

Practice location:
  • Phone: 740-676-6600
  • Fax:
Mailing address:
  • Phone: 304-243-3124
  • Fax: 304-243-1131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: JANICE ELAINE RIESMEYER
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 304-243-3124