Princeton Memorial Hospital Company

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

126 Issued in WV

Legal business name

PRINCETON MEMORIAL HOSPITAL COMPANY

Practice address

James Monroe Dr and US RT 219
Lindside, WV 24951

Phone

(304) 753-4332

Fax

(304) 753-4334

NPI assigned

Aug 10, 2005

Organization subpart

No

Name

Mr. Patrick A Smith, NHA CEO

Title

President

Phone

(304) 425-3203

• Springfield Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841291960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 101A",
            "city": "LINDSIDE",
            "state": "WV",
            "postal_code": "249519612",
            "telephone_number": "304-753-4332",
            "fax_number": "304-753-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "JAMES MONROE DR AND US RT 219",
            "city": "LINDSIDE",
            "state": "WV",
            "postal_code": "24951",
            "telephone_number": "304-753-4332",
            "fax_number": "304-753-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON MEMORIAL HOSPITAL COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-425-3203",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA CEO"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WV",
            "license": "126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010087000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springfield Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erica Neice
• Lisa Oliver
• April Marie Parker
• Kent Patrick, LPC
• Janice Marie Peplowski, RN
• Ruth Ann Riffe, MSW, LICSW
• Sierra L Robertson, RN
• Shaina Celeste Rose, CNA, CCMA
• Seneca Trail Leasing Co., LLC
• Crystal Lynn Spicer

• All providers in Lindside, WV
• Skilled Nursing Facility in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.