Provider Demographics
NPI:1154517118
Name:STONEWALL JACKSON MEMORIAL HOSPITAL MED GROUP
Entity type:Organization
Organization Name:STONEWALL JACKSON MEMORIAL HOSPITAL MED GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHERICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-269-8050
Mailing Address - Street 1:230 HOSPITAL PLAZA
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452
Mailing Address - Country:US
Mailing Address - Phone:304-269-8000
Mailing Address - Fax:304-269-8090
Practice Address - Street 1:230 HOSPITAL PLZ
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-8558
Practice Address - Country:US
Practice Address - Phone:304-269-8000
Practice Address - Fax:304-269-8090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-24
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital