Healthcare Provider Details

I. General information

NPI: 1013905702
Provider Name (Legal Business Name): REYNOLDS MEMORIAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2005
Last Update Date: 01/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WHEELING AVE
GLEN DALE WV
26038-1660
US

IV. Provider business mailing address

800 WHEELING AVE
GLEN DALE WV
26038-1660
US

V. Phone/Fax

Practice location:
  • Phone: 304-843-3211
  • Fax: 304-843-3202
Mailing address:
  • Phone: 304-843-3211
  • Fax: 304-843-3202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number63
License Number StateWV

VIII. Authorized Official

Name: DR. DAVID F HESS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 304-845-3211