Provider Demographics
NPI:1568406254
Name:WHEELING HOSPITAL, INC.
Entity Type:Organization
Organization Name:WHEELING HOSPITAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:SIMONS
Authorized Official - Suffix:
Authorized Official - Credentials:R PH
Authorized Official - Phone:304-243-3278
Mailing Address - Street 1:1 MEDICAL PARK
Mailing Address - Street 2:PHARMACY
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6379
Mailing Address - Country:US
Mailing Address - Phone:304-243-3278
Mailing Address - Fax:304-243-6422
Practice Address - Street 1:1 MEDICAL PARK
Practice Address - Street 2:PHARMACY
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6379
Practice Address - Country:US
Practice Address - Phone:304-243-3278
Practice Address - Fax:304-243-6422
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVIP05504113336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0001131000Medicaid