Provider Demographics
NPI:1750791646
Name:RALEIGH GENERAL HOSPITAL LLC
Entity type:Organization
Organization Name:RALEIGH GENERAL HOSPITAL LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAPLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-920-7000
Mailing Address - Street 1:PO BOX 553
Mailing Address - Street 2:
Mailing Address - City:MABSCOTT
Mailing Address - State:WV
Mailing Address - Zip Code:25871-0553
Mailing Address - Country:US
Mailing Address - Phone:304-461-3909
Mailing Address - Fax:304-461-3916
Practice Address - Street 1:1717 HARPER RD FL 2
Practice Address - Street 2:SUITE G
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3373
Practice Address - Country:US
Practice Address - Phone:304-461-3909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5100702Medicare PIN