1023196391 NPI number — UNITED HOSPITAL CENTER, INC

Table of content: (NPI 1023196391)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023196391 NPI number — UNITED HOSPITAL CENTER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED HOSPITAL CENTER, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023196391
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/23/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
527 MEDICAL PARK DRIVE
Provider Second Line Business Mailing Address:
STE 402
Provider Business Mailing Address City Name:
BRIDGEPORT
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26330
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
681-342-3590
Provider Business Mailing Address Fax Number:
681-342-3507

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
527 MEDICAL PARK DRIVE
Provider Second Line Business Practice Location Address:
STE 402
Provider Business Practice Location Address City Name:
BRIDGEPORT
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26330
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
681-342-3590
Provider Business Practice Location Address Fax Number:
681-342-3507
Provider Enumeration Date:
11/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MEADOWS
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR OF CORPORATE COMPLIANCE
Authorized Official Telephone Number:
681-342-1610

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X , with the licence number:  107 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001793480 . This is a "MSBCBS PAY TO NUMBER" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 9336515 . This is a "MEDICARE PTAN" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




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