Provider Demographics
NPI:1093230211
Name:WHEELING HOSPITAL INC
Entity Type:Organization
Organization Name:WHEELING HOSPITAL INC
Other - Org Name:BRIDGEPORT HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:RIESMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-243-3124
Mailing Address - Street 1:1 MEDICAL PARK BUSINESS OFFICE NTTC
Mailing Address - Street 2:JANICE RIESMEYER
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6379
Mailing Address - Country:US
Mailing Address - Phone:304-243-3124
Mailing Address - Fax:304-243-1131
Practice Address - Street 1:55741 NATIONAL RD
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:OH
Practice Address - Zip Code:43912-1528
Practice Address - Country:US
Practice Address - Phone:740-635-4572
Practice Address - Fax:740-635-4575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1514276Medicaid