Healthcare Provider Details

I. General information

NPI: 1760404800
Provider Name (Legal Business Name): HEALTH MANAGEMENT ASSOCIATES OF WV
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 COLLEGE HL
WILLIAMSON WV
25661-3300
US

IV. Provider business mailing address

701 COLLEGE HL PO BOX 1958
WILLIAMSON WV
25661-3300
US

V. Phone/Fax

Practice location:
  • Phone: 304-235-2930
  • Fax: 304-235-2933
Mailing address:
  • Phone: 304-235-2930
  • Fax: 304-235-2933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateWV

VIII. Authorized Official

Name: MRS. MELINDA EDWARDS
Title or Position: ASST. PRACTICE MANAGER
Credential:
Phone: 304-235-0466