Provider Demographics
NPI:1023196391
Name:UNITED HOSPITAL CENTER, INC
Entity Type:Organization
Organization Name:UNITED HOSPITAL CENTER, INC
Other - Org Name:UHC PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CORPORATE COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEADOWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:681-342-1610
Mailing Address - Street 1:527 MEDICAL PARK DRIVE
Mailing Address - Street 2:STE 402
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330
Mailing Address - Country:US
Mailing Address - Phone:681-342-3590
Mailing Address - Fax:681-342-3507
Practice Address - Street 1:527 MEDICAL PARK DRIVE
Practice Address - Street 2:STE 402
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330
Practice Address - Country:US
Practice Address - Phone:681-342-3590
Practice Address - Fax:681-342-3507
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED HOSPITAL CENTER DBA UHC PAIN MANAGEMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-02
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV107207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001793480OtherMSBCBS PAY TO NUMBER
WV9336515OtherMEDICARE PTAN