Healthcare Provider Details

I. General information

NPI: 1710840251
Provider Name (Legal Business Name): SELBY GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 STATE ROUTE 664 N UNIT A
LOGAN OH
43138-9250
US

IV. Provider business mailing address

416 COLEGATE DR BLDG 3
MARIETTA OH
45750-9549
US

V. Phone/Fax

Practice location:
  • Phone: 740-385-9646
  • Fax: 740-689-4430
Mailing address:
  • Phone: 740-374-6090
  • Fax: 740-374-3165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAUL G WESTBROCK
Title or Position: VP, LEGAL AFFAIRS
Credential:
Phone: 740-374-1581