Provider Demographics
NPI:1518930213
Name:WEST VIRGINIA REHABILITATION HOSPITAL INC
Entity Type:Organization
Organization Name:WEST VIRGINIA REHABILITATION HOSPITAL INC
Other - Org Name:ENCOMPASS HEALTH REHABILITATION HOSPITAL OF MORGANTOWN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:WISNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-970-5702
Mailing Address - Street 1:9001 LIBERTY PKWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-7509
Mailing Address - Country:US
Mailing Address - Phone:205-967-7116
Mailing Address - Fax:205-969-6650
Practice Address - Street 1:1160 VAN VOORHIS RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-3437
Practice Address - Country:US
Practice Address - Phone:304-598-1100
Practice Address - Fax:304-598-1103
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENCOMPASS HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-02-12
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV154283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
121299869OtherMED PLUS
30868OtherCARELINK
MD0002015000Medicaid
55067090OtherBLUE CROSS
030071OtherFEDERAL BLACK LUNG
N808OtherHEALTH PLAN
000324392OtherBLUE CROSS
PA0822640Medicaid
OH098215600Medicaid
30868OtherCARELINK
MD0002015000Medicaid