MEDICARE: ST. JOSEPH'S HOSPITAL OF BUCKHANNON, 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	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1780223370
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. JOSEPH'S HOSPITAL OF BUCKHANNON, INC.

Provider Business Mailing Address
First Line	:	1 AMALIA DR
Second Line	:
City	:	BUCKHANNON
State	:	WV
Zip	:	26201-2239
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	94 W MAIN ST
Second Line	:
City	:	BUCKHANNON
State	:	WV
Zip	:	26201-2284
Country	:	US
Telephone Number	:	304-473-2202
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	FOREST HANNAH
Credential	:
Telephone Number	:	304-872-2891

Provider Enumeration Date	:	12/30/2019
Last Update Date	:	06/03/2026

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