# POTOMAC VALLEY HOSPITAL OF W VA , INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** POTOMAC VALLEY HOSPITAL OF W VA , INC
- **Other names:** Mineral County Rural Health Clinic of Potomac Valley Hospital
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1467090449
- **Legal business name:** POTOMAC VALLEY HOSPITAL OF W VA , INC
- **Authorized official:** SUE A WELLS (SENIOR DIRECTOR OF CLINIC OPERATION)
- **Authorized official phone:** (304) 597-3525

## Contact information

- **Practice address:** 100 PIN OAK LN STE 3, KEYSER, WV 26726-5908
- **Practice address phone:** (304) 597-3790
- **Practice address fax:** (304) 597-3564
- **Mailing address:** 1370 JOHNSON AVE STE 102, BRIDGEPORT, WV 26330-1492
- **Mailing address phone:** (681) 342-3453
- **Mailing address fax:** (304) 842-2333

## Taxonomy

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

## Other

- **Enumeration date:** 12/20/2019
- **Last updated:** 12/20/2019