Healthcare Provider Details

I. General information

NPI: 1962472548
Provider Name (Legal Business Name): ST MARYS MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 FIRST AVE
HUNTINGTON WV
25702
US

IV. Provider business mailing address

2900 FIRST AVE
HUNTINGTON WV
25702
US

V. Phone/Fax

Practice location:
  • Phone: 304-526-1014
  • Fax: 304-526-1021
Mailing address:
  • Phone: 304-526-1014
  • Fax: 304-526-1021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number46
License Number StateWV

VIII. Authorized Official

Name: ANGELA SWEARINGEN
Title or Position: COO
Credential:
Phone: 304-526-1224