MEDICARE: PLEASANT VALLEY HOSPITAL

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	251E00000X	Home Health Agency	06	WV

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568455509
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLEASANT VALLEY HOSPITAL

Provider Business Mailing Address
First Line	:	1011 VIAND ST
Second Line	:
City	:	POINT PLEASANT
State	:	WV
Zip	:	25550-1242
Country	:	US
Telephone Number	:	304-675-7400
Fax Number	:	304-675-7401

Provider Business Practice Location Address
First Line	:	1011 VIAND ST
Second Line	:
City	:	PT PLEASANT
State	:	WV
Zip	:	25550-1242
Country	:	US
Telephone Number	:	304-675-7400
Fax Number	:	304-675-7401

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. TRINA HANNAN
Credential	:	RN
Telephone Number	:	304-675-7400

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	08/22/2020

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1649112533 — WILMA COTTRELL
Practice Location Address:

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1396798898 — POINT PLEASANT PHYSICIAN BILLING SERVICES
Practice Location Address:

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Directions to “PLEASANT VALLEY HOSPITAL ” Practice Location

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