Provider Demographics
NPI:1073518007
Name:CABELL HUNTINGTON HOSPITAL INC
Entity Type:Organization
Organization Name:CABELL HUNTINGTON HOSPITAL INC
Other - Org Name:CABELL HUNTINGTON HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP & COO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-256-2052
Mailing Address - Street 1:1340 HAL GREER BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3800
Mailing Address - Country:US
Mailing Address - Phone:304-526-2000
Mailing Address - Fax:304-526-4846
Practice Address - Street 1:1340 HAL GREER BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3800
Practice Address - Country:US
Practice Address - Phone:304-526-2000
Practice Address - Fax:304-526-4846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV48282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000138976Medicaid
WV272203OtherMAMSI PROV ID
KY000000054452OtherANTHEM KY
WV001710104OtherWV BC BS
WV0001144000Medicaid
WV000312421OtherBLUE CROSS
KY01690049Medicaid
OH1217758Medicaid
KY000000061917OtherANTHEM KY LAB ONLY #
WV1073518007Medicaid
KY000000061917OtherANTHEM KY LAB ONLY #
OH=========00OtherOH WCOMP PROVIDER ID
OH000000138976Medicaid
WV272203OtherMAMSI PROV ID
OH=========001Medicaid