# SUMMERSVILLE REGIONAL MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Summersville Memorial Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174513808
- **Authorized official:** DEBORAH ALICE KINCELL (REVENUE CYCLE DIRECTOR)
- **Authorized official phone:** (304) 883-0252

## Contact information

- **Practice address:** 400 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 26651-9308
- **Practice address phone:** (304) 872-2891
- **Practice address fax:** (304) 872-6854
- **Mailing address:** 400 FAIRVIEW HEIGHTS RD, SUMMERSVILLE, WV 26651-9308
- **Mailing address phone:** (304) 872-2891
- **Mailing address fax:** (304) 872-6854

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 61 | WV | Yes |
| 314000000X | Skilled Nursing Facility | 61 | WV | — |

## Other

- **Enumeration date:** 10/25/2005
- **Last updated:** 12/21/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0001243001 | — | WV |