Provider Demographics
NPI:1427549039
Name:UNITED HOSPITAL CENTER, INC.
Entity Type:Organization
Organization Name:UNITED HOSPITAL CENTER, INC.
Other - Org Name:UHC PULMONOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TILLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:681-342-1600
Mailing Address - Street 1:1370 JOHNSON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330-1378
Mailing Address - Country:US
Mailing Address - Phone:681-342-3730
Mailing Address - Fax:304-842-9422
Practice Address - Street 1:1370 JOHNSON AVE STE 201
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330-1378
Practice Address - Country:US
Practice Address - Phone:681-342-3730
Practice Address - Fax:304-842-9422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-21
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty