Healthcare Provider Details

I. General information

NPI: 1891350179
Provider Name (Legal Business Name): BLUEFIELD HOSPITAL COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2019
Last Update Date: 05/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CHERRY ST
BLUEFIELD WV
24701-3306
US

IV. Provider business mailing address

500 CHERRY ST
BLUEFIELD WV
24701-3306
US

V. Phone/Fax

Practice location:
  • Phone: 304-327-1100
  • Fax: 304-324-2628
Mailing address:
  • Phone: 304-327-1100
  • Fax: 304-324-2628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: PAULA LALOR
Title or Position: DIRECTOR
Credential:
Phone: 615-925-4565