Basic Information
Provider Information
NPI: 1316017171
EntityType: 2
ReplacementNPI:  
OrganizationName: WHEELING HOSPITAL INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: BELLAIRE COMMUNITY HEALTH CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 MEDICAL PARK BUSINESS OFFICE NTTC
Address2: JANICE RIESMEYER
City: WHEELING
State: WV
PostalCode: 260036397
CountryCode: US
TelephoneNumber: 3042433124
FaxNumber: 3042433124
Practice Location
Address1: 3000 GUERNSEY ST
Address2:  
City: BELLAIRE
State: OH
PostalCode: 439061540
CountryCode: US
TelephoneNumber: 7406764623
FaxNumber: 7406716333
Other Information
ProviderEnumerationDate: 11/09/2006
LastUpdateDate: 03/25/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: RIESMEYER
AuthorizedOfficialFirstName: JANICE
AuthorizedOfficialMiddleName: ELAINE
AuthorizedOfficialTitleorPosition: CREDENTIALING COORDINATOR
AuthorizedOfficialTelephone: 3042433124
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: WHEELING HOSPITAL INC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QP2300X  Y Ambulatory Health Care FacilitiesClinic/CenterPrimary Care

No ID Information.


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