Provider Demographics
NPI:1306929476
Name:UNITED HOSPITAL CENTER, INC
Entity type:Organization
Organization Name:UNITED HOSPITAL CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CORPORATE COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEADOWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:681-342-1610
Mailing Address - Street 1:527 MEDICAL PARK DRIVE
Mailing Address - Street 2:STE 401
Mailing Address - City:BRIDGEPORT
Mailing Address - State:WV
Mailing Address - Zip Code:26330
Mailing Address - Country:US
Mailing Address - Phone:681-342-3500
Mailing Address - Fax:681-342-3561
Practice Address - Street 1:527 MEDICAL PARK DRIVE
Practice Address - Street 2:STE 401
Practice Address - City:BRIDGEPORT
Practice Address - State:WV
Practice Address - Zip Code:26330
Practice Address - Country:US
Practice Address - Phone:681-342-3500
Practice Address - Fax:681-342-3561
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITED HOSPITAL CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-23
Last Update Date:2014-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20050207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV000814588OtherBLUE CROSS SERVICE #
WVUN9336511Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER