Braxton County Memorial Hospital

Organization Active NPI Home Health Registered Nurse · Gassaway, WV

NPI 1043259229 · NPPES record last updated Nov 20, 2018

Key facts

NPI
1043259229
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Registered Nurse 163WH0200X
Legal business name
BRAXTON COUNTY MEMORIAL HOSPITAL
Practice address
100 Hoylman Dr
Gassaway, WV 26624-9321
Phone
(304) 364-1063
Fax
(304) 364-8637
NPI assigned
Jun 5, 2006
Organization subpart
Yes
Parent organization (as reported)
BRAXTON COUNTY MEMORIAL HOSPITAL

Authorized official

Name
Kimberly Dawn Knight
Title
Cfo
Phone
(304) 364-1128

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

National Provider Directory

Part of
Gary F Roberts MD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse
Group: 193200000X MULTI-SPECIALTY GROUP
163WH0200X Yes
Home Health Aide
Group: 193200000X MULTI-SPECIALTY GROUP
374U00000X

Addresses

Primary practice location

100 Hoylman Dr
Gassaway, WV 26624-9321

Mailing address

100 Hoylman Dr
Gassaway, WV 26624-9321
Phone (304) 364-1063

Other identifiers

IdentifierTypeStateIssuer
001703819OtherWVBLUE CROSS
306997OtherWVFEDERAL BLACK LUNG
0001734001MedicaidWV

Other providers in Gassaway, WV

All providers in Gassaway, WV · Home Health Registered Nurse in West Virginia

Sources for this page

Verify at the official NPI Registry.