1811958267 NPI number — HOSPITAL DEVELOPMENT CO

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811958267 NPI number — HOSPITAL DEVELOPMENT CO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOSPITAL DEVELOPMENT CO
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:
ROANE GENERAL HOSPITAL SKILLED NURSING FACILITY
Provider Other Organization Name Type Code:
5
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:
1811958267
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/12/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 HOSPITAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPENCER
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25276-1050
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-927-4444
Provider Business Mailing Address Fax Number:
304-927-6840

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 HOSPITAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPENCER
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25276-1050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-927-4444
Provider Business Practice Location Address Fax Number:
304-927-6840
Provider Enumeration Date:
03/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BENTZ
Authorized Official First Name:
DOUG
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
304-927-6200

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  74 , 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)





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