Provider Demographics
NPI:1083606230
Name:HAHN MEDICAL PRACTICES, INC.
Entity Type:Organization
Organization Name:HAHN MEDICAL PRACTICES, INC.
Other - Org Name:HARDY COUNTY MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-822-8134
Mailing Address - Street 1:PO BOX 599
Mailing Address - Street 2:
Mailing Address - City:MOOREFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:26836-0599
Mailing Address - Country:US
Mailing Address - Phone:304-538-2331
Mailing Address - Fax:304-538-2533
Practice Address - Street 1:422 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MOOREFIELD
Practice Address - State:WV
Practice Address - Zip Code:26836-1238
Practice Address - Country:US
Practice Address - Phone:304-538-2331
Practice Address - Fax:304-538-2533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-15
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV15226207NS0135X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0034515000Medicaid
WV000180632OtherWV BLUE SHIELD
WV513859Medicare ID - Type UnspecifiedMEDICARE