Healthcare Provider Details

I. General information

NPI: 1477608727
Provider Name (Legal Business Name): GRAFTON CITY HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 01/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARKET ST
GRAFTON WV
26354-1184
US

IV. Provider business mailing address

500 MARKET ST
GRAFTON WV
26354-1184
US

V. Phone/Fax

Practice location:
  • Phone: 304-265-0400
  • Fax: 304-265-6419
Mailing address:
  • Phone: 304-265-0400
  • Fax: 304-265-6419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: PATRICK D SHAW
Title or Position: CEO
Credential:
Phone: 304-265-0400