Healthcare Provider Details

I. General information

NPI: 1255547402
Provider Name (Legal Business Name): OAK HILL HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 11/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 MAIN ST W
OAK HILL WV
25901-3414
US

IV. Provider business mailing address

430 MAIN ST W
OAK HILL WV
25901-3414
US

V. Phone/Fax

Practice location:
  • Phone: 304-469-8600
  • Fax: 304-469-8605
Mailing address:
  • Phone: 304-469-8600
  • Fax: 304-469-8605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateWV

VIII. Authorized Official

Name: DEBBIE T BREWER
Title or Position: DIRECTOR OF PROVIDER ENROLLMENT
Credential:
Phone: 615-465-7626