Provider Demographics
NPI:1699778704
Name:WEBSTER COUNTY MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:WEBSTER COUNTY MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:RIFFLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:304-847-5682
Mailing Address - Street 1:PO BOX 312
Mailing Address - Street 2:324 MILLER MOUNTAIN DRIVE
Mailing Address - City:WEBSTER SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:26288
Mailing Address - Country:US
Mailing Address - Phone:304-847-5682
Mailing Address - Fax:304-847-5985
Practice Address - Street 1:324 MILLER MOUNTAIN DR
Practice Address - Street 2:
Practice Address - City:WEBSTER SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:26288-1026
Practice Address - Country:US
Practice Address - Phone:304-847-5682
Practice Address - Fax:304-847-5985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1449282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1053679282OtherNPI
WV1639264582OtherNPI
WV1255661955OtherNPI
WV1730415332OtherNPI
WV1013203058OtherNPI
WV1760776272OtherNPI
WV1174788111OtherNPI
WV1992078380OtherNPI
WV1437453719OtherNPI
WV1720243769OtherNPI
WV1639264582OtherNPI
WV1053679282OtherNPI
WV1760776272OtherNPI
WV1437453719OtherNPI
WVE93359Medicare UPIN
WVQ75197Medicare UPIN
WV1174788111OtherNPI