Healthcare Provider Details

I. General information

NPI: 1265484893
Provider Name (Legal Business Name): GRAFTON CITY HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 06/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL PLZ
GRAFTON WV
26354-1283
US

IV. Provider business mailing address

1 HOSPITAL PLZ
GRAFTON WV
26354-1283
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 Code282NC0060X
TaxonomyCritical Access Hospital
License Number14
License Number StateWV

VIII. Authorized Official

Name: JEFFREY E LILLEY
Title or Position: ADMINISTRATOR
Credential:
Phone: 304-265-0400