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Organization
STONEWALL JACKSON MEMORIAL HOSPITAL
Active
Organization
STONEWALL JACKSON MEMORIAL HOSPITAL
Active
Other names
Lively Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID D SHAFFER (CEO)
(304) 269-8000
Entity
Organization
Contact information
Practice address
533 HACKERS CREEK RD, JANE LEW, WV 26378-8394
(304) 884-8941
(304) 884-8943
Mailing address
230 HOSPITAL PLZ, WESTON, WV 26452-8558
(304) 269-8000
(304) 269-8090
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19972
WV
Other
Enumeration date
06/19/2008
Last updated
06/26/2008
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