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NPI Code Detail

MEDICARE: GRANT MEMORIAL HOSPITAL

MEDICARE: GRANT MEMORIAL 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
1275N00000XMedicare Defined Swing Bed Hospital Unit21WV
2282N00000XGeneral Acute Care Hospital21WV
3282NC0060XCritical Access Hospital21WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598763666
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRANT MEMORIAL HOSPITAL
Provider Business Mailing Address
First Line : PO BOX 1019
Second Line :
City : PETERSBURG
State : WV
Zip : 26847-1019
Country : US
Telephone Number : 304-257-1026
Fax Number : 304-257-1932
Provider Business Practice Location Address
First Line : 117 HOSPITAL DR
Second Line :
City : PETERSBURG
State : WV
Zip : 26847-9566
Country : US
Telephone Number : 304-257-1026
Fax Number : 304-257-1932
Authorized Official
Title or Position : CEO
Name : MR. ROBERT W MILVET JR.
Credential :
Telephone Number : 304-257-1026
Provider Enumeration Date : 07/12/2005
Last Update Date : 02/14/2019

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Directions to “GRANT MEMORIAL HOSPITAL ” Practice Location

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