Healthcare Provider Details

I. General information

NPI: 1457200156
Provider Name (Legal Business Name): CITY HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2026
Last Update Date: 01/26/2026
Certification Date: 01/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 SOMERSET BLVD STE 101
CHARLES TOWN WV
25414-3954
US

IV. Provider business mailing address

PO BOX 990
MORGANTOWN WV
26507-0990
US

V. Phone/Fax

Practice location:
  • Phone: 304-725-2663
  • Fax:
Mailing address:
  • Phone: 304-264-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: GROVER GLENDON KERNS III
Title or Position: VP OF FINANCE
Credential:
Phone: 304-260-1443