Provider Demographics
NPI:1740221332
Name:WAR MEMORIAL HOSPITAL, INC.
Entity Type:Organization
Organization Name:WAR MEMORIAL HOSPITAL, INC.
Other - Org Name:BERKELY SPRINGS INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-258-1234
Mailing Address - Street 1:109 WAR MEMORIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:25411-1743
Mailing Address - Country:US
Mailing Address - Phone:304-258-1234
Mailing Address - Fax:304-258-6127
Practice Address - Street 1:226 GAYLE DRIVE
Practice Address - Street 2:
Practice Address - City:BERKELEY SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:25411-6301
Practice Address - Country:US
Practice Address - Phone:304-258-9433
Practice Address - Fax:304-258-6063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9362162Medicare ID - Type Unspecified