Healthcare Provider Details

I. General information

NPI: 1043594971
Provider Name (Legal Business Name): CABELL HUNTINGTON HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2011
Last Update Date: 11/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 HAL GREER BLVD NEURO PHYSIOLOGY LAB
HUNTINGTON WV
25701-3800
US

IV. Provider business mailing address

1340 HAL GREER BLVD
HUNTINGTON WV
25701-3800
US

V. Phone/Fax

Practice location:
  • Phone: 304-526-6387
  • Fax: 304-526-6327
Mailing address:
  • Phone: 304-526-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: KEVIN FOWLER
Title or Position: CEO
Credential:
Phone: 304-526-2000