Provider Demographics
NPI:1164490041
Name:WHEELING HOSPITAL INC
Entity Type:Organization
Organization Name:WHEELING HOSPITAL INC
Other - Org Name:BELMONT COMMUNITY HOSPITAL PHARMACY
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 1:3000 GUERNSEY ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:OH
Mailing Address - Zip Code:43906-1540
Mailing Address - Country:US
Mailing Address - Phone:740-676-4062
Mailing Address - Fax:740-671-6333
Practice Address - Street 1:3000 GUERNSEY ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:OH
Practice Address - Zip Code:43906-1540
Practice Address - Country:US
Practice Address - Phone:740-676-4062
Practice Address - Fax:740-671-6333
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHEELING HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-08
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH021185900333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1514276Medicaid
OH1514276Medicaid