1285862136 NPI number — ACUITY SPECIALTY HOSPITAL - OHIO VALLEY, LP

Table of content: (NPI 1285862136)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285862136 NPI number — ACUITY SPECIALTY HOSPITAL - OHIO VALLEY, LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACUITY SPECIALTY HOSPITAL - OHIO VALLEY, LP
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:
ACUITY SPECIALTY HOSPITAL - OHIO VALLEY AT WHEELING
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:
1285862136
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/05/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4714 GETTYSBURG RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MECHANICSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17055-4325
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-972-1100
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 MEDICAL PARK FL 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHEELING
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26003-7600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-238-5750
Provider Business Practice Location Address Fax Number:
304-242-9031
Provider Enumeration Date:
06/30/2009

Additional Information

Authorized Official

Authorized Official Last Name:
TARVIN
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
VP
Authorized Official Telephone Number:
717-972-1100

Provider Taxonomy Codes

  • Taxonomy code: 282E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 51200500 . This is a "MEDICARE OSCAR/CERTIFICATION" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 164 . This is a "HOSPITAL LICENSE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 2611865 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com