Healthcare Provider Details

I. General information

NPI: 1659752004
Provider Name (Legal Business Name): WEBSTER COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2015
Last Update Date: 06/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6815 WEBSTER ROAD
COWEN WV
26206
US

IV. Provider business mailing address

6815 WEBSTER ROAD
COWEN WV
26206
US

V. Phone/Fax

Practice location:
  • Phone: 304-226-3600
  • Fax: 304-226-3601
Mailing address:
  • Phone: 304-226-3600
  • Fax: 304-226-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateWV

VIII. Authorized Official

Name: MRS. JULIE CLUTTER
Title or Position: ACCOUNTANT
Credential:
Phone: 304-847-5682