Healthcare Provider Details

I. General information

NPI: 1790745677
Provider Name (Legal Business Name): HOSPITAL DEVELOPMENT CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 11/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 LIBRARY LN
LEFT HAND WV
25251-9745
US

IV. Provider business mailing address

200 HOSPITAL DR
SPENCER WV
25276-1050
US

V. Phone/Fax

Practice location:
  • Phone: 304-927-6819
  • Fax: 304-927-6837
Mailing address:
  • Phone: 304-927-6819
  • Fax: 304-927-6837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number74
License Number StateWV

VIII. Authorized Official

Name: DOUG BENTZ
Title or Position: CEO
Credential:
Phone: 304-927-6200