Provider Demographics
NPI:1508160268
Name:CAMDEN CLARK MEMORIAL HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:CAMDEN CLARK MEMORIAL HOSPITAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-424-2111
Mailing Address - Street 1:800 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-5340
Mailing Address - Country:US
Mailing Address - Phone:304-424-2111
Mailing Address - Fax:
Practice Address - Street 1:1824 MURDOCH AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3230
Practice Address - Country:US
Practice Address - Phone:304-424-4111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-10
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810020360Medicaid
WV13142Medicaid
OH1252602Medicaid
WV13142Medicaid