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General NPI Number Information
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NPI Number | 1144031634
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Entity Type | Organization
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Legal Business Name | POTOMAC VALLEY HOSPITAL OF W VA , INC
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 819 S MINERAL ST
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City | KEYSER
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State | WV
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Zip | 26726-8218
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Country | US
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Telephone | 304-597-3633
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Fax |
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Provider Business Mailing Address
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Address Line | 819 S MINERAL ST
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City | KEYSER
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State | WV
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Zip | 26726
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SR DIRECTOR OF PROV SERVICES
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Name | SUE A WELLS
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Credential |
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Telephone | 304-597-3525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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