Provider Demographics
NPI:1437411766
Name:VETERNS HOSPITAL OF CLARKSBURG
Entity Type:Organization
Organization Name:VETERNS HOSPITAL OF CLARKSBURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNNLAP
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE MANAGER
Authorized Official - Phone:304-623-3461
Mailing Address - Street 1:5 WIMER AVE
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-2435
Mailing Address - Country:US
Mailing Address - Phone:304-704-6030
Mailing Address - Fax:
Practice Address - Street 1:5 WIMER AVE
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-2435
Practice Address - Country:US
Practice Address - Phone:304-704-6030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV50810282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural