Healthcare Provider Details

I. General information

NPI: 1639216039
Provider Name (Legal Business Name): WETZEL COUNTY HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 07/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FAIR AVE
MIDDLEBOURNE WV
26149-9622
US

IV. Provider business mailing address

PO BOX 244
NEW MARTINSVILLE WV
26155-0244
US

V. Phone/Fax

Practice location:
  • Phone: 304-758-5100
  • Fax: 304-758-4646
Mailing address:
  • Phone: 304-455-8006
  • Fax: 304-455-8075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: EDWIN SZEWCZYK
Title or Position: CFO
Credential:
Phone: 304-455-8013