Provider Demographics
NPI:1124234778
Name:BLUEFIELD REGIONAL MEDICAL CENTER
Entity type:Organization
Organization Name:BLUEFIELD REGIONAL MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WHITTEKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-327-1100
Mailing Address - Street 1:106 HUFFARD DR
Mailing Address - Street 2:
Mailing Address - City:BLUEFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:24605-9209
Mailing Address - Country:US
Mailing Address - Phone:276-322-3427
Mailing Address - Fax:276-322-4640
Practice Address - Street 1:106 HUFFARD DR
Practice Address - Street 2:
Practice Address - City:BLUEFIELD
Practice Address - State:VA
Practice Address - Zip Code:24605-9209
Practice Address - Country:US
Practice Address - Phone:276-322-3427
Practice Address - Fax:276-322-4640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA493998Medicare Oscar/Certification