1063499887 NPI number — UNITED HOSPITAL CENTER, INC

Table of content: (NPI 1063499887)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063499887 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:
PEOPLE'S HOSPICE
Provider Other Organization Name Type Code:
3
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:
1063499887
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
327 MEDICAL PARK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRIDGEPORT
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26330-9006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
681-342-3200
Provider Business Mailing Address Fax Number:
681-342-3125

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
327 MEDICAL PARK DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRIDGEPORT
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26330-9006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
681-342-3200
Provider Business Practice Location Address Fax Number:
681-342-3125
Provider Enumeration Date:
12/22/2005

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: 251G00000X , with the licence number:  0487290 , 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: 0001276004 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 511502A . This is a "MEDICARE PTAN" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".