Healthcare Provider Details

I. General information

NPI: 1386720019
Provider Name (Legal Business Name): OHIO VALLEY MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 12/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 EOFF ST
WHEELING WV
26003-3823
US

IV. Provider business mailing address

2000 EOFF ST
WHEELING WV
26003-3823
US

V. Phone/Fax

Practice location:
  • Phone: 304-234-0123
  • Fax:
Mailing address:
  • Phone: 304-234-8663
  • Fax: 304-234-8960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number05
License Number StateWV

VIII. Authorized Official

Name: KIMBERLY S WARD
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 304-234-8663