=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053342303
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAMPSHIRE MEMORIAL HOSPITAL, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/05/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 549 CENTER AVE
-----------------------------------------------------
City | ROMNEY
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26757-1352
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-822-4561
-----------------------------------------------------
Fax | 304-822-7809
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 549 CENTER AVE
-----------------------------------------------------
City | ROMNEY
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26757-1352
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-822-4561
-----------------------------------------------------
Fax | 304-822-7809
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. HAROLD A MCBEE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 410-643-3393
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number | 02
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------