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General NPI Number Information
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NPI Number | 1972302388
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Entity Type | Organization
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Legal Business Name | MARIETTA MEMORIAL HOSPITAL OF TYLER COUNTY INC
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 424 HIGHLAND AVE
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City | WILLIAMSTOWN
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State | WV
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Zip | 26187-1249
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Country | US
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Telephone | 740-568-4190
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Fax | 740-568-4195
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Provider Business Mailing Address
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Address Line | 314 S WELLS ST
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City | SISTERSVILLE
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State | WV
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Zip | 26175-1098
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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 LEGAL AFFAIRS
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Name | PAUL G WESTBROCK
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Credential |
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Telephone | 740-374-1581
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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