Provider Demographics
NPI:1275596777
Name:BOONE MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:BOONE MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BLITZ
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN-BC
Authorized Official - Phone:304-369-1230
Mailing Address - Street 1:HC 64 BOX 350
Mailing Address - Street 2:
Mailing Address - City:RIDGEVIEW
Mailing Address - State:WV
Mailing Address - Zip Code:25169-9702
Mailing Address - Country:US
Mailing Address - Phone:304-369-6114
Mailing Address - Fax:
Practice Address - Street 1:701 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WV
Practice Address - Zip Code:25130-1669
Practice Address - Country:US
Practice Address - Phone:304-369-1230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV43850282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access