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General NPI Number Information
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NPI Number | 1720960479
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Entity Type | Organization
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Legal Business Name | CITY HOSPITAL, INC.
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 880 N TENNESSEE AVE STE 105B
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City | MARTINSBURG
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State | WV
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Zip | 25401-9401
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Country | US
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Telephone | 304-596-5757
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 990
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City | MORGANTOWN
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State | WV
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Zip | 26507-0990
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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 | VP OF FINANCE
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Name | GROVER GLENDON KERNS
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Credential |
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Telephone | 304-260-1443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | 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 | 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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