Provider Demographics
NPI:1760404800
Name:HEALTH MANAGEMENT ASSOCIATES OF WV
Entity Type:Organization
Organization Name:HEALTH MANAGEMENT ASSOCIATES OF WV
Other - Org Name:WILLIAMSON FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST. PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-235-0466
Mailing Address - Street 1:701 COLLEGE HL
Mailing Address - Street 2:PO BOX 1958
Mailing Address - City:WILLIAMSON
Mailing Address - State:WV
Mailing Address - Zip Code:25661-3300
Mailing Address - Country:US
Mailing Address - Phone:304-235-2930
Mailing Address - Fax:304-235-2933
Practice Address - Street 1:701 COLLEGE HL
Practice Address - Street 2:
Practice Address - City:WILLIAMSON
Practice Address - State:WV
Practice Address - Zip Code:25661-3300
Practice Address - Country:US
Practice Address - Phone:304-235-2930
Practice Address - Fax:304-235-2933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVHE5100771Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER