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General NPI Number Information
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NPI Number | 1942432687
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Entity Type | Organization
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Legal Business Name | ST MARY'S HOSPITALIST SERVICES, LLC
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Dates
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Enumeration Date | 08/13/2009
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 2900 1ST AVE RM 1025
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City | HUNTINGTON
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State | WV
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Zip | 25702-1241
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Country | US
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Telephone | 304-399-7484
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Fax | 304-399-7579
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Provider Business Mailing Address
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Address Line | 5170 US RT 60 EAST
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City | HUNTINGTON
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State | WV
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Zip | 25705
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Country | US
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Telephone | 304-528-4600
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Fax | 304-733-3143
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Authorized Official
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Title or Position | COO
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Name | MARK MORGAN
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Credential |
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Telephone | 304-528-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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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 | 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 #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | WV
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