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General NPI Number Information
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NPI Number | 1528879277
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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 | 01/14/2025
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 131 STAGGS LN
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City | KEYSER
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State | WV
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Zip | 26726-7003
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Country | US
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Telephone | 304-597-3597
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Fax |
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Provider Business Mailing Address
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Address Line | 131 STAGGS LN
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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 | 304-597-3597
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Fax |
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Authorized Official
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Title or Position | SR DIRECTOR OF PROVIDER 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 | 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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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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