Provider Demographics
NPI:1164121703
Name:MARIETTA MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:MARIETTA MEMORIAL HOSPITAL
Other - Org Name:DEPT. OF PRIMARY CARE-BARLOW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, LEGAL AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:G
Authorized Official - Last Name:WESTBROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-374-1581
Mailing Address - Street 1:401 MATTHEW ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-1635
Mailing Address - Country:US
Mailing Address - Phone:740-374-6090
Mailing Address - Fax:740-374-3165
Practice Address - Street 1:40 WHITE OAK PROFESSIONAL CTR
Practice Address - Street 2:
Practice Address - City:VINCENT
Practice Address - State:OH
Practice Address - Zip Code:45784-9117
Practice Address - Country:US
Practice Address - Phone:740-678-2374
Practice Address - Fax:740-678-8139
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARIETTA MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-02
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health