Provider Demographics
NPI:1114913449
Name:WHEELING HOSPITAL INC
Entity Type:Organization
Organization Name:WHEELING HOSPITAL INC
Other - Org Name:CONTINUOUS CARE CENTER WHEELING HOSPITAL
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
Mailing Address - Street 2:BUSINESS OFFICE NTTC-CREDENTIALING
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 1:236 HULLIHEN PL
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-8311
Practice Address - Country:US
Practice Address - Phone:304-243-3800
Practice Address - Fax:304-243-3100
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHEELING HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-22
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV68313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0001131001Medicaid
WV0001131001Medicaid