Healthcare Provider Details

I. General information

NPI: 1316984487
Provider Name (Legal Business Name): CHARLESTON HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 LAIDLEY ST
CHARLESTON WV
25301-1614
US

IV. Provider business mailing address

PO BOX 471
CHARLESTON WV
25322-0471
US

V. Phone/Fax

Practice location:
  • Phone: 304-347-6500
  • Fax: 304-347-6885
Mailing address:
  • Phone: 304-347-6500
  • Fax: 304-347-6885

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: RENEE CROSS
Title or Position: CFO
Credential:
Phone: 304-347-6663