Provider Demographics
NPI:1104821305
Name:WHEELING HOSPITAL INC
Entity type:Organization
Organization Name:WHEELING HOSPITAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:RIESMEYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-243-3124
Mailing Address - Street 1:1 MEDICAL PARK
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6379
Mailing Address - Country:US
Mailing Address - Phone:304-243-3000
Mailing Address - Fax:304-243-3060
Practice Address - Street 1:1 MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003
Practice Address - Country:US
Practice Address - Phone:304-243-3124
Practice Address - Fax:304-243-6343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2023-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV89282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5100501OtherMEDICARE PART B
OH9384750Medicaid
WV0001131000Medicaid
WV300047OtherBLACK LUNG PROVIDER NUMBE
WV0001131002Medicaid
WV001742046OtherMOUNTAIN STATE BLUE CROSS SKILLED
WV001742046OtherMOUNTAIN STATE BLUE CROSS SKILLED
OH9384750Medicaid