Healthcare Provider Details

I. General information

NPI: 1861416315
Provider Name (Legal Business Name): PLEASANT VALLEY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 08/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 VALLEY DR
POINT PLEASANT WV
25550-2031
US

IV. Provider business mailing address

2520 VALLEY DR
POINT PLEASANT WV
25550-2031
US

V. Phone/Fax

Practice location:
  • Phone: 304-674-2412
  • Fax: 304-675-7150
Mailing address:
  • Phone: 304-674-2412
  • Fax: 304-675-7150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License NumberIP0550785
License Number StateWV

VIII. Authorized Official

Name: JOHN BEAVER
Title or Position: PHARMACY DIRECTOR
Credential: RPH
Phone: 304-674-2412