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General NPI Number Information
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NPI Number | 1700663226
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Entity Type | Organization
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Legal Business Name | DAVIS MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 09/08/2023
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 812 GORMAN AVE
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City | ELKINS
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State | WV
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Zip | 26241-3181
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Country | US
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Telephone | 304-636-6767
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1484
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City | ELKINS
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State | WV
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Zip | 26241-1484
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Country | US
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Telephone | 304-636-6767
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | WILLIAM LLOYD KOCH
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Credential |
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Telephone | 304-637-3196
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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 |
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License Number State |
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