Basic Information
| Provider Information | |||||||||
| NPI: | 1548993603 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MINNIE HAMILTON HEALTH CARE CENTER INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 186 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | GRANTSVILLE | ||||||||
| State: | WV | ||||||||
| PostalCode: | 261477100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043545978 | ||||||||
| FaxNumber: | 3043545963 | ||||||||
| Practice Location | |||||||||
| Address1: | 80 SPRING RUN ROAD | ||||||||
| Address2: | |||||||||
| City: | ARNOLDSBURG | ||||||||
| State: | WV | ||||||||
| PostalCode: | 25234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3043545995 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2022 | ||||||||
| LastUpdateDate: | 07/08/2022 | ||||||||
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| AuthorizedOfficialLastName: | WHITED | ||||||||
| AuthorizedOfficialFirstName: | STEPHEN | ||||||||
| AuthorizedOfficialMiddleName: | SCOTT | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3043549735 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | MINNIE HAMILTON HEALTH CARE CENTER INC | ||||||||
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| NPICertificationDate: | 07/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.