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NPI Code Detail

MEDICARE: POTOMAC VALLEY HOSPITAL OF W VA, INC

MEDICARE: POTOMAC VALLEY HOSPITAL OF W VA, 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
1275N00000XMedicare Defined Swing Bed Hospital Unit02WV

Other Identifiers

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

General Provider Information

NPI Number : 1770536112
Entity Type Code : Organization
Provider Name (Legal Business Name) : POTOMAC VALLEY HOSPITAL OF W VA, INC
Provider Business Mailing Address
First Line : 100 PIN OAK LN
Second Line :
City : KEYSER
State : WV
Zip : 26726-5908
Country : US
Telephone Number : 304-597-3500
Fax Number : 304-597-3507
Provider Business Practice Location Address
First Line : 100 PIN OAK LN
Second Line :
City : KEYSER
State : WV
Zip : 26726-5908
Country : US
Telephone Number : 304-597-3510
Fax Number : 304-597-3507
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. LINDA K SHROYER
Credential :
Telephone Number : 304-597-3510
Provider Enumeration Date : 05/18/2006
Last Update Date : 07/29/2014

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