MEDICARE: REYNOLDS MEMORIAL 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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1568391688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REYNOLDS MEMORIAL HOSPITAL INC

Provider Business Mailing Address
First Line	:	PO BOX 616
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26507-0616
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 EOFF ST
Second Line	:
City	:	BENWOOD
State	:	WV
Zip	:	26031-1007
Country	:	US
Telephone Number	:	304-221-3014
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DOUGLASS EDWARD HARRISON
Credential	:
Telephone Number	:	304-243-3263

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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