Healthcare Provider Details

I. General information

NPI: 1891703740
Provider Name (Legal Business Name): RALEIGH GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 HARPER RD
BECKLEY WV
25801-3357
US

IV. Provider business mailing address

PO BOX 16068
HIGH POINT NC
27261-6068
US

V. Phone/Fax

Practice location:
  • Phone: 304-256-4102
  • Fax:
Mailing address:
  • Phone: 888-447-7220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS STESLICKI
Title or Position: INTERIM CFO
Credential:
Phone: 304-256-4102