Basic Information
| Provider Information | |||||||||
| NPI: | 1295030161 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EAST OHIO REGIONAL HOSPITAL | ||||||||
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| OtherOrganizationName: | EORH PHYSICIAN ASSISTANTS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 109 MOUNT WOOD RD | ||||||||
| Address2: | |||||||||
| City: | WHEELING | ||||||||
| State: | WV | ||||||||
| PostalCode: | 260032632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042332455 | ||||||||
| FaxNumber: | 3042336073 | ||||||||
| Practice Location | |||||||||
| Address1: | 90 N 4TH ST | ||||||||
| Address2: | |||||||||
| City: | MARTINS FERRY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439351648 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7406331100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2011 | ||||||||
| LastUpdateDate: | 03/25/2013 | ||||||||
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| AuthorizedOfficialLastName: | WARD | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
| AuthorizedOfficialMiddleName: | SUE | ||||||||
| AuthorizedOfficialTitleorPosition: | CRED. COORD. | ||||||||
| AuthorizedOfficialTelephone: | 3042348663 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.