Provider Demographics
NPI:1578669248
Name:CITY HOSPITAL, INC.
Entity Type:Organization
Organization Name:CITY HOSPITAL, INC.
Other - Org Name:UNIVERSITY HEALTHCARE AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZELENKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-264-1249
Mailing Address - Street 1:59 RULAND RD
Mailing Address - Street 2:UNIT H
Mailing Address - City:KEARNEYSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25430-2887
Mailing Address - Country:US
Mailing Address - Phone:304-728-1750
Mailing Address - Fax:304-728-1791
Practice Address - Street 1:59 RULAND RD
Practice Address - Street 2:UNIT H
Practice Address - City:KEARNEYSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25430-2887
Practice Address - Country:US
Practice Address - Phone:304-728-1750
Practice Address - Fax:304-728-1791
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST VIRGINIA UNIVERSITY HOSPITALS EAST INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-16
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV103251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0001199001Medicaid
WV0001199001Medicaid