Provider Demographics
NPI:1114468113
Name:WHEELING HOSPITAL INC
Entity Type:Organization
Organization Name:WHEELING HOSPITAL INC
Other - Org Name:GROUX CLINIC, A DIVISION OF WHEELING HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:VIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-243-3263
Mailing Address - Street 1:40 MEDICAL PARK
Mailing Address - Street 2:SUITE 504
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6392
Mailing Address - Country:US
Mailing Address - Phone:304-242-0588
Mailing Address - Fax:304-242-7267
Practice Address - Street 1:40 MEDICAL PARK
Practice Address - Street 2:SUITE 504
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6392
Practice Address - Country:US
Practice Address - Phone:304-242-0588
Practice Address - Fax:304-242-7267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV89207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0001131002OtherMEDICAID
WV0001131000Medicaid
WVWH5100501Medicare PIN
WV0001131000Medicaid