Healthcare Provider Details

I. General information

NPI: 1639168693
Provider Name (Legal Business Name): CHARLESTON AREA MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 MORRIS ST
CHARLESTON WV
25301-1326
US

IV. Provider business mailing address

501 MORRIS ST
CHARLESTON WV
25301-1326
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-3322
  • Fax: 304-388-3978
Mailing address:
  • Phone: 304-388-3322
  • Fax: 304-388-3978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number20
License Number StateWV

VIII. Authorized Official

Name: MR. STEPHEN Z BELL
Title or Position: VP OF FINANCE
Credential:
Phone: 304-388-6251