MEDICARE: CABELL HUNTINGTON HOSPITAL, 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	207T00000X	Neurological Surgery Physician

General Provider Information

NPI Number	:	1447595624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CABELL HUNTINGTON HOSPITAL, INC

Provider Business Mailing Address
First Line	:	1340 HAL GREER BLVD
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-3800
Country	:	US
Telephone Number	:	304-399-6819
Fax Number	:

Provider Business Practice Location Address
First Line	:	1305 ELM ST E
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-3861
Country	:	US
Telephone Number	:	304-399-6819
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KEVIN FOWLER
Credential	:
Telephone Number	:	304-526-2000

Provider Enumeration Date	:	11/29/2012
Last Update Date	:	11/20/2015

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