Provider Demographics
NPI:1508825530
Name:OHIO VALLEY GENERAL HOSPITAL
Entity Type:Organization
Organization Name:OHIO VALLEY GENERAL HOSPITAL
Other - Org Name:ACUTE REHAB UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:PROVENZANO
Authorized Official - Suffix:
Authorized Official - Credentials:FACHE
Authorized Official - Phone:412-777-6280
Mailing Address - Street 1:25 HECKEL RD
Mailing Address - Street 2:
Mailing Address - City:MC KEES ROCKS
Mailing Address - State:PA
Mailing Address - Zip Code:15136-1651
Mailing Address - Country:US
Mailing Address - Phone:412-777-6161
Mailing Address - Fax:
Practice Address - Street 1:25 HECKEL RD
Practice Address - Street 2:
Practice Address - City:MC KEES ROCKS
Practice Address - State:PA
Practice Address - Zip Code:15136-1651
Practice Address - Country:US
Practice Address - Phone:412-777-6161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA150401273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007502820024Medicaid
PA1264OtherHIGHMARK
PA1264OtherHIGHMARK