# LOGAN GENERAL HOSPITAL LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Logan Regional Primary Care - Holden
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255064531
- **Authorized official:** JOHNETTA TRAYLOR (AO)
- **Authorized official phone:** (502) 596-6063

## Contact information

- **Practice address:** 1690 HOLDEN RD, LOGAN, WV 25601-7026
- **Practice address phone:** (304) 239-2147
- **Practice address fax:** (304) 239-2309
- **Mailing address:** 680 S 4TH ST, LOUISVILLE, KY 40202-2407
- **Mailing address phone:** (502) 596-6063

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/05/2022
- **Last updated:** 06/25/2025