Healthcare Provider Details

I. General information

NPI: 1821018177
Provider Name (Legal Business Name): CAMDEN CLARK MEMORIAL HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 10/06/2023
Certification Date: 10/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 GARFIELD AVE
PARKERSBURG WV
26101-5340
US

IV. Provider business mailing address

800 GARFIELD AVE P O BOX 718
PARKERSBURG WV
26101-5340
US

V. Phone/Fax

Practice location:
  • Phone: 304-424-2111
  • Fax: 304-424-2853
Mailing address:
  • Phone: 304-424-2111
  • Fax: 304-424-2853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number102
License Number StateWV

VIII. Authorized Official

Name: MR. ALLEN R BUTCHER
Title or Position: VICE PRESIDENT OF FINANCE
Credential:
Phone: 304-424-2202