Healthcare Provider Details

I. General information

NPI: 1306655972
Provider Name (Legal Business Name): POTOMAC VALLEY HOSPITAL OF W VA , INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10261 FRANKFORT HWY
FORT ASHBY WV
26719-4533
US

IV. Provider business mailing address

10261 FRANKFORT HWY
FORT ASHBY WV
26719-4533
US

V. Phone/Fax

Practice location:
  • Phone: 304-597-3600
  • Fax: 304-285-3963
Mailing address:
  • Phone: 304-597-3600
  • Fax: 304-285-3963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: SUE A WELLS
Title or Position: SR DIRECTOR PROVIDER SUPPORT SERV
Credential:
Phone: 304-597-3525