MEDICARE: UNITED HOSPITAL CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	107	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	CI9203	OTHER	WV	RAILROAD MEDICARE GROUP

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	001709473	OTHER	WV	BLUE CROSSBLUESHIELDGROUP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134101660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED HOSPITAL CENTER INC

Provider Business Mailing Address
First Line	:	527 MEDICAL PARK DR
Second Line	:	SUITE 500
City	:	BRIDGEPORT
State	:	WV
Zip	:	26330-9010
Country	:	US
Telephone Number	:	681-342-3600
Fax Number	:	681-342-3625

Provider Business Practice Location Address
First Line	:	527 MEDICAL PARK DR
Second Line	:	SUITE 500
City	:	BRIDGEPORT
State	:	WV
Zip	:	26330-9010
Country	:	US
Telephone Number	:	681-342-3600
Fax Number	:	681-342-3625

Authorized Official
Title or Position	:	DIRECTOR OF CORPORATE COMPLIANCE
Name	:	STEVEN MEADOWS
Credential	:
Telephone Number	:	681-342-1610

Provider Enumeration Date	:	11/18/2005
Last Update Date	:	03/30/2014

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Directions to “UNITED HOSPITAL CENTER INC ” Practice Location

Language	Start Address	Practice Location

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