Provider Demographics
NPI:1659752004
Name:WEBSTER COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:WEBSTER COUNTY MEMORIAL HOSPITAL
Other - Org Name:COWEN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-847-5682
Mailing Address - Street 1:6815 WEBSTER ROAD
Mailing Address - Street 2:
Mailing Address - City:COWEN
Mailing Address - State:WV
Mailing Address - Zip Code:26206
Mailing Address - Country:US
Mailing Address - Phone:304-226-3600
Mailing Address - Fax:304-226-3601
Practice Address - Street 1:6815 WEBSTER ROAD
Practice Address - Street 2:
Practice Address - City:COWEN
Practice Address - State:WV
Practice Address - Zip Code:26206
Practice Address - Country:US
Practice Address - Phone:304-226-3600
Practice Address - Fax:304-226-3601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy