NPIMap

Organization Active NPI

Reynolds Memorial Hospital, Inc.

Doing business as Reynolds Memorial Hospital Home Infusion

  • Home Infusion Therapy Pharmacy
  • Glen Dale, WV
National Provider Identifier
1861698953
Registry record updated Aug 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion Therapy PharmacyTaxonomy code 3336H0001X
License
OP0551193 Issued in WV
Legal business name
REYNOLDS MEMORIAL HOSPITAL, INC.
Doing business as
Reynolds Memorial Hospital Home Infusion
Practice address
800 Wheeling Ave
2ND Floor
Glen Dale, WV 26038-1660
Phone
(304) 853-3379
NPI assigned
Jun 25, 2007
Last updated
Aug 11, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
REYNOLDS MEMORIAL HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 11, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John A. Sicurella
Title
Ceo
Phone
(304) 843-3379

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X OP0551193 WV
Home Infusion Therapy Pharmacy 3336H0001X OP0551193 WV Primary

Addresses

Primary practice location

800 Wheeling Ave
2ND Floor
Glen Dale, WV 26038-1660

Mailing address

800 Wheeling Ave
2ND Floor
Glen Dale, WV 26038-1660
Phone (304) 853-3379

Other identifiers 3

IdentifierTypeStateIssuer
001748043OtherWVMT. STATE BCBS
INF045OtherWVUPPER OHIO VALLEY HP PROV
0001309003MedicaidWV

Other names 1

  • Reynolds Memorial Hospital Home Infusion Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Reynolds Mem Hosp DP S7 organizations share this tax ID, including this one
Part of
Reynolds Mem Hosp DP S

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1861698953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WHEELING AVE",
            "address_2": "2ND FLOOR",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381660",
            "telephone_number": "304-853-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WHEELING AVE",
            "address_2": "2ND FLOOR",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "260381660",
            "telephone_number": "304-853-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REYNOLDS MEMORIAL HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "REYNOLDS MEMORIAL HOSPITAL, INC.",
        "enumeration_date": "2007-06-25",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "SICURELLA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "304-843-3379"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "WV",
            "license": "OP0551193",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "WV",
            "license": "OP0551193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT. STATE BCBS",
            "identifier": "001748043",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPPER OHIO VALLEY HP PROV",
            "identifier": "INF045",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001309003",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reynolds Memorial Hospital Home Infusion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Dale, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.