Healthcare Provider Details

I. General information

NPI: 1578669248
Provider Name (Legal Business Name): CITY HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 RULAND RD UNIT H
KEARNEYSVILLE WV
25430-2887
US

IV. Provider business mailing address

59 RULAND RD UNIT H
KEARNEYSVILLE WV
25430-2887
US

V. Phone/Fax

Practice location:
  • Phone: 304-728-1750
  • Fax: 304-728-1791
Mailing address:
  • Phone: 304-728-1750
  • Fax: 304-728-1791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number103
License Number StateWV

VIII. Authorized Official

Name: MR. TONY ZELENKA
Title or Position: CAO
Credential:
Phone: 304-264-1249