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General NPI Number Information
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NPI Number | 1194269589
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Entity Type | Organization
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Legal Business Name | UNITED HOSPITAL CENTER, INC.
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Dates
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Enumeration Date | 12/05/2016
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Last Update Date | 12/16/2016
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Provider Practice Location Address
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Address Line | 177 MIDDLETOWN RD STE 1
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City | WHITE HALL
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State | WV
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Zip | 26554-8254
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Country | US
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Telephone | 304-363-6600
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Fax | 304-333-5201
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Provider Business Mailing Address
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Address Line | 527 MEDICAL PARK DR STE 400
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City | BRIDGEPORT
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State | WV
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Zip | 26330-9010
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Country | US
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Telephone | 681-342-3500
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Fax | 681-342-3507
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL TILLMAN
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Credential |
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Telephone | 681-342-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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