Provider Demographics
NPI:1457389249
Name:CITY HOSPITAL, INC
Entity Type:Organization
Organization Name:CITY HOSPITAL, INC
Other - Org Name:BERKELEY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:QUINONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-260-1443
Mailing Address - Street 1:PO BOX 990
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26507-0990
Mailing Address - Country:US
Mailing Address - Phone:304-598-6795
Mailing Address - Fax:304-598-6381
Practice Address - Street 1:2500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-3402
Practice Address - Country:US
Practice Address - Phone:304-264-1249
Practice Address - Fax:304-264-1340
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST VIRGINIA UNIVERSITY HOSPITALS EAST INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-29
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV80282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV000301259OtherACUTE HOSPITAL
WV0001292000Medicaid
WV0001292000Medicaid
WV510008Medicare Oscar/Certification