Healthcare Provider Details

I. General information

NPI: 1427378330
Provider Name (Legal Business Name): WHEELING HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2010
Last Update Date: 10/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL PARK
WHEELING WV
26003-6379
US

IV. Provider business mailing address

1 MEDICAL PARK
WHEELING WV
26003-6379
US

V. Phone/Fax

Practice location:
  • Phone: 304-243-3388
  • Fax: 304-243-6422
Mailing address:
  • Phone: 304-243-3388
  • Fax: 304-243-6422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberOP0552216
License Number StateWV

VIII. Authorized Official

Name: MR. LANCE J GOSSETT
Title or Position: PHARMACIST IN CHARGE
Credential:
Phone: 304-243-3739