Healthcare Provider Details

I. General information

NPI: 1003020991
Provider Name (Legal Business Name): HOPE MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

74 TECHNOLOGY LN
COWEN WV
26206-3702
US

IV. Provider business mailing address

74 TECHNOLOGY DRIVE
COWEN WV
26206
US

V. Phone/Fax

Practice location:
  • Phone: 304-226-5527
  • Fax: 304-226-5531
Mailing address:
  • Phone: 304-226-5527
  • Fax: 304-226-5531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK JASON HARDWAY
Title or Position: OWNER
Credential: MD
Phone: 304-226-5527