Basic Information
| Provider Information | |||||||||
| NPI: | 1598847634 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WEST VIRGINIA UNIVERSITY HOSPITALS INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1127 | ||||||||
| Address2: | |||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 265071127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3045984032 | ||||||||
| FaxNumber: | 3045984143 | ||||||||
| Practice Location | |||||||||
| Address1: | 608 CHEAT RD | ||||||||
| Address2: | |||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 265084210 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3045941313 | ||||||||
| FaxNumber: | 3045942408 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2006 | ||||||||
| LastUpdateDate: | 05/12/2020 | ||||||||
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| AuthorizedOfficialLastName: | WRIGHT | ||||||||
| AuthorizedOfficialFirstName: | ALBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 3045984000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 05/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 208000000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3810001961 | 05 | WV | MEDICAID | 1007552330008 | 05 | PA | MEDICAID |