Provider Demographics
NPI:1750831558
Name:WEIRTON MEDICAL CENTER INC
Entity Type:Organization
Organization Name:WEIRTON MEDICAL CENTER INC
Other - Org Name:WEIRTON MEDICAL CENTER HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF HOME CARE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JOI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GORLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:304-797-6495
Mailing Address - Street 1:601 COLLIERS WAY
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-5014
Mailing Address - Country:US
Mailing Address - Phone:304-797-6495
Mailing Address - Fax:304-797-6496
Practice Address - Street 1:100 WELDAY AVE STE E
Practice Address - Street 2:
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953-3779
Practice Address - Country:US
Practice Address - Phone:304-797-6495
Practice Address - Fax:304-797-6496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV120251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health