Provider Demographics
NPI:1508316308
Name:WEIRTON MEDICAL CENTER INC
Entity Type:Organization
Organization Name:WEIRTON MEDICAL CENTER INC
Other - Org Name:WEIRTON MEDICAL CENTER HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF HOME CARE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JOI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GORLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSV
Authorized Official - Phone:304-797-6495
Mailing Address - Street 1:400 MARKET PLACE DR
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15071-4007
Mailing Address - Country:US
Mailing Address - Phone:304-797-6495
Mailing Address - Fax:304-797-6496
Practice Address - Street 1:601 COLLIERS WAY
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-5014
Practice Address - Country:US
Practice Address - Phone:304-797-6495
Practice Address - Fax:304-797-6496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV120251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health