Healthcare Provider Details

I. General information

NPI: 1780645127
Provider Name (Legal Business Name): HOSPITAL DEVELOPMENT CO. DBA ROANE GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HOSPITAL DR
SPENCER WV
25276-1050
US

IV. Provider business mailing address

200 HOSPITAL DR
SPENCER WV
25276-1050
US

V. Phone/Fax

Practice location:
  • Phone: 304-927-6514
  • Fax: 304-927-6807
Mailing address:
  • Phone: 304-927-6514
  • Fax: 304-927-6807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number74
License Number StateWV

VIII. Authorized Official

Name: DOUG BENTZ
Title or Position: CEO
Credential:
Phone: 304-927-6200