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General NPI Number Information
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NPI Number | 1134521966
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Entity Type | Organization
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Legal Business Name | CAMDEN ON GAULEY MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 09/24/2014
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Last Update Date | 12/10/2021
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Provider Practice Location Address
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Address Line | 415 MAIN ST
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City | SUMMERSVILLE
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State | WV
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Zip | 26651-1343
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Country | US
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Telephone | 304-872-1663
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Fax | 304-872-1804
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Provider Business Mailing Address
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Address Line | 415 MAIN ST
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City | SUMMERSVILLE
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State | WV
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Zip | 26651-1343
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Country | US
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Telephone | 304-872-1663
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Fax | 304-872-1804
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Authorized Official
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Title or Position | CEO
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Name | MARGARET HICKEY
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Credential |
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Telephone | 304-266-5725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | S0552479
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License Number State | WV
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