Healthcare Provider Details

I. General information

NPI: 1427627058
Provider Name (Legal Business Name): CHARLESTON AREA MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2021
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3948 TEAYS VALLEY RD
HURRICANE WV
25526-8728
US

IV. Provider business mailing address

501 MORRIS ST
CHARLESTON WV
25301-1300
US

V. Phone/Fax

Practice location:
  • Phone: 304-760-7265
  • Fax: 304-760-7266
Mailing address:
  • Phone: 304-388-1724
  • Fax: 304-388-1721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. MEREDITH KIP RICE
Title or Position: VP FINANCE ADMINISTRATION
Credential:
Phone: 304-388-6041