NPIMap

Organization Active NPI

Camden on Gauley Medical Center Inc

  • Clinical Medical Laboratory
  • Camden on Gauley, WV
National Provider Identifier
1871633727
Registry record updated Jan 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
035736 Issued in WV
Legal business name
CAMDEN ON GAULEY MEDICAL CENTER INC
Practice address
10003 Webster Road
Camden on Gauley, WV 26208-0000
Phone
(304) 226-5725
Fax
(304) 226-3274
NPI assigned
Feb 8, 2007
Last updated
Jan 21, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2009

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

Authorized official

Name
Judith Lynn Hamrick
Title
Administrator
Phone
(304) 226-5725

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 035736 WV Primary

Addresses

Primary practice location

10003 Webster Road
Camden on Gauley, WV 26208-0000

Mailing address

PO Box 69
Camden on Gauley, WV 26208-0069
Phone (304) 226-5725

Other identifiers 5

IdentifierTypeStateIssuer
0035222006MedicaidWV
001709708OtherWVMS BCBS
5197060OtherWVAETNA
CC5506OtherWVRR MEDICARE
51D0017142OtherWVCLIA-CAMDEN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D0017142Camden on Gauley Medical Center, Inc Dba10003 Webster Road, Camden on Gauley, WV 26208Provider-performed microscopyJul 12, 2027

National Provider Directory

National Provider Directory
Tax ID family
Camden on Gauley Medica21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1871633727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "city": "CAMDEN ON GAULEY",
            "state": "WV",
            "postal_code": "262080069",
            "telephone_number": "304-226-5725",
            "fax_number": "304-226-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10003 WEBSTER ROAD",
            "city": "CAMDEN ON GAULEY",
            "state": "WV",
            "postal_code": "262080000",
            "telephone_number": "304-226-5725",
            "fax_number": "304-226-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMDEN ON GAULEY MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "HAMRICK",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "304-226-5725"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WV",
            "license": "035736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035222006",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS BCBS",
            "identifier": "001709708",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5197060",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CC5506",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA-CAMDEN",
            "identifier": "51D0017142",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden on Gauley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.