Healthcare Provider Details

I. General information

NPI: 1770103475
Provider Name (Legal Business Name): WHEELING HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2020
Last Update Date: 04/22/2020
Certification Date: 04/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 PLAZA DR
SAINT CLAIRSVILLE OH
43950-8786
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 740-695-1381
  • Fax: 740-695-6379
Mailing address:
  • Phone: 304-243-3124
  • Fax: 304-243-1131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

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