Provider Demographics
NPI:1588632251
Name:WHEELING HOSPITAL INC
Entity Type:Organization
Organization Name:WHEELING HOSPITAL INC
Other - Org Name:POWHATAN HEALTH CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:RIESMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-243-3124
Mailing Address - Street 1:63 HIGHWAY 7 S
Mailing Address - Street 2:
Mailing Address - City:POWHATAN POINT
Mailing Address - State:OH
Mailing Address - Zip Code:43942-1143
Mailing Address - Country:US
Mailing Address - Phone:740-795-4837
Mailing Address - Fax:740-795-4867
Practice Address - Street 1:63 HIGHWAY 7 S
Practice Address - Street 2:
Practice Address - City:POWHATAN POINT
Practice Address - State:OH
Practice Address - Zip Code:43942-1143
Practice Address - Country:US
Practice Address - Phone:740-795-4837
Practice Address - Fax:740-795-4867
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WHEELING HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-09
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH021185950333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2147706Medicaid
OH2147706Medicaid