1952390239 NPI number — CHARLESTON AREA MEDICAL CENTER INC

Table of content: (NPI 1952390239)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952390239 NPI number — CHARLESTON AREA MEDICAL CENTER INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHARLESTON AREA MEDICAL 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:
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:
1952390239
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/30/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 MORRIS ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLESTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25301-1326
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-388-3322
Provider Business Mailing Address Fax Number:
304-388-3978

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 MORRIS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-388-3322
Provider Business Practice Location Address Fax Number:
304-388-3978
Provider Enumeration Date:
10/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BELL
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
Z
Authorized Official Title or Position:
VP OF FINANCE
Authorized Official Telephone Number:
304-388-6251

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  20 , 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: 0268688 . This is a "OHIO MEDICAID" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 241779 . This is a "MAMSI" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 030293300 . This is a "BLACK LUNG" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 14130 . This is a "CARELINK PEIA SVI" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 510022 . This is a "CARELINK ACUTE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: N045 . This is a "THE HEALTH PLAN" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 000324349 . This is a "BLUE CROSS ACUTE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 13118 . This is a "CARELINK MEDICAID" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 211066 . This is a "CARELINK PEIA SURG" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 404375307 . This is a "MICHIGAN MEDICAID" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0001342000 . This is a "UNICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 304675290 . This is a "MICHIGAN MEDICAID" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0001342000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 224707800 . This is a "FEDERAL WC" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 241779 . This is a "ALLIANCE PPO" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




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