Provider Demographics
NPI:1730255738
Name:WETZEL COUNTY HOSPITAL ASSOCIATION
Entity type:Organization
Organization Name:WETZEL COUNTY HOSPITAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:T
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-455-8195
Mailing Address - Street 1:3 EAST BENJAMIN DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW MARTINSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26155-2705
Mailing Address - Country:US
Mailing Address - Phone:304-455-8000
Mailing Address - Fax:304-455-4259
Practice Address - Street 1:3 EAST BENJAMIN DRIVE
Practice Address - Street 2:
Practice Address - City:NEW MARTINSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26155-2705
Practice Address - Country:US
Practice Address - Phone:304-455-8000
Practice Address - Fax:304-455-4259
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WETZEL COUNTY HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-28
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV95275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9370345Medicaid
001703751OtherBCBS
N015OtherHEALTH PLAN UPPER OH VALL
001703751OtherBCBS
N015OtherHEALTH PLAN UPPER OH VALL