Healthcare Provider Details

I. General information

NPI: 1619964806
Provider Name (Legal Business Name): DAVIS MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 GORMAN AVE
ELKINS WV
26241-3181
US

IV. Provider business mailing address

PO BOX 1484
ELKINS WV
26241-1484
US

V. Phone/Fax

Practice location:
  • Phone: 304-636-3300
  • Fax: 304-637-3435
Mailing address:
  • Phone: 304-636-3300
  • Fax: 304-637-3435

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number141
License Number StateWV

VIII. Authorized Official

Name: MRS. MELANIE DEMPSEY
Title or Position: INTERIM CFO
Credential:
Phone: 304-637-3471