Healthcare Provider Details

I. General information

NPI: 1861973547
Provider Name (Legal Business Name): HIGHLAND-CLARKSBURG HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 08/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 HOSPITAL PLZ
CLARKSBURG WV
26301-9316
US

IV. Provider business mailing address

3 HOSPITAL PLZ
CLARKSBURG WV
26301-9316
US

V. Phone/Fax

Practice location:
  • Phone: 304-969-3100
  • Fax:
Mailing address:
  • Phone: 304-969-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateWV

VIII. Authorized Official

Name: NANCY MICHELLE GIAQUINTO
Title or Position: CFO
Credential:
Phone: 304-969-3100