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NPI 1790608891

NPI 1790608891 : POTOMAC VALLEY HOSPITAL OF W VA , INC : KEYSER, WV

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General NPI Number Information
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    NPI Number           |    1790608891
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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     |    08/04/2026
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    Last Update Date     |    08/04/2026
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Provider Practice Location Address
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    Address Line         |    147 PLAZA DR 
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    City                 |    KEYSER
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    State                |    WV
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    Zip                  |    26726-6015
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    Country              |    US
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    Telephone            |    304-597-2404
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    Fax                  |    304-597-2403
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Provider Business Mailing Address
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    Address Line         |    147 PLAZA DRIVE 
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    City                 |    KEYSER
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    State                |    WV
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    Zip                  |    26726-6015
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    Country              |    US
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    Telephone            |    304-597-2404
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    Fax                  |    304-597-2403
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Authorized Official
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    Title or Position    |    DIR PROV SUPPORT 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        |    207X00000X
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    Taxonomy Name        |    Orthopaedic Surgery 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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