Healthcare Provider Details

I. General information

NPI: 1104681014
Provider Name (Legal Business Name): HERBERT J THOMAS MEMORIAL HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2024
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 LAIDLEY ST
CHARLESTON WV
25301-1614
US

IV. Provider business mailing address

PO BOX 744145
ATLANTA GA
30384-2907
US

V. Phone/Fax

Practice location:
  • Phone: 304-347-6500
  • Fax: 304-347-6885
Mailing address:
  • Phone: 804-267-4670
  • Fax: 804-267-4671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: RACHEL STEPHANIE JONES
Title or Position: CFO
Credential:
Phone: 304-766-3600