Healthcare Provider Details

I. General information

NPI: 1104035328
Provider Name (Legal Business Name): HAMPSHIRE MEMORIAL HOSPITAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 02/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 SUNRISE BLVD
ROMNEY WV
26757-4607
US

IV. Provider business mailing address

549 CENTER AVE
ROMNEY WV
26757-1352
US

V. Phone/Fax

Practice location:
  • Phone: 304-822-4561
  • Fax: 304-822-7809
Mailing address:
  • Phone: 304-822-4561
  • Fax: 304-822-7809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number69
License Number StateWV

VIII. Authorized Official

Name: GERALD J BECHAMPS
Title or Position: VICE PRESIDENT, MEDICAL AFFAIRS
Credential: MD
Phone: 540-536-5100