Provider Demographics
NPI:1649323130
Name:CHAPMANVILLE MEDICAL CENTER, INC
Entity type:Organization
Organization Name:CHAPMANVILLE MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDEVITT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:304-855-4000
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:CHAPMANVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25508-0099
Mailing Address - Country:US
Mailing Address - Phone:304-855-4000
Mailing Address - Fax:304-855-1067
Practice Address - Street 1:BOX 99 MAIN STREET
Practice Address - Street 2:
Practice Address - City:CHAPMANVILLE
Practice Address - State:WV
Practice Address - Zip Code:25508-0099
Practice Address - Country:US
Practice Address - Phone:304-855-4000
Practice Address - Fax:304-855-1067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1665261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center