Provider Demographics
NPI:1093897175
Name:CITY HOSPITAL INC
Entity Type:Organization
Organization Name:CITY HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VICE PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:APPLEBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-264-1000
Mailing Address - Street 1:2500 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-1418
Mailing Address - Country:US
Mailing Address - Phone:304-264-1247
Mailing Address - Fax:304-264-1279
Practice Address - Street 1:2000 FOUNDATION WAY
Practice Address - Street 2:SUITE 2200
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-1418
Practice Address - Country:US
Practice Address - Phone:304-264-1247
Practice Address - Fax:304-264-1279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16562282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVF32385Medicare UPIN