Provider Demographics
NPI:1194930875
Name:LOGAN REGIONAL MEDICAL CENTER
Entity type:Organization
Organization Name:LOGAN REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT BUSINESS OFFICE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAFFERTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-831-1901
Mailing Address - Street 1:20 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:WV
Mailing Address - Zip Code:25601-3452
Mailing Address - Country:US
Mailing Address - Phone:304-831-1101
Mailing Address - Fax:304-831-1937
Practice Address - Street 1:20 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601-3452
Practice Address - Country:US
Practice Address - Phone:304-831-1101
Practice Address - Fax:304-831-1937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1700839438OtherNPI REHAB
WV1750332565OtherNPI ACUTE
WV1295789675OtherNPI SWING