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Organization
GRANT MEMORIAL HOSPITAL
Active
Organization
GRANT MEMORIAL HOSPITAL
Active
Other names
GRANT MEMORIAL HOSPITAL
Organization subpart
No
Provider details
NPI number
Authorized official
BRENTON HARMAN RPH (PIC)
(304) 257-1026
Entity
Organization
Contact information
Practice address
117 HOSPITAL DR, PETERSBURG, WV 26847-9566
(304) 257-1026
(304) 257-9622
Mailing address
117 HOSPITAL DR, PO BOX 1019, PETERSBURG, WV 26847-9566
(304) 257-1026
(304) 257-9622
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
NULL
333600000X
Pharmacy
—
NULL
3336C0004X
Compounding Pharmacy
—
NULL
3336I0012X
Institutional Pharmacy
Primary
IP0550877
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2109651
PK
—
Enumeration date
08/07/2007
Last updated
02/16/2017
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