# MINNIE HAMILTON HEALTH CARE CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MINNIE HAMILTON HEALTH CARE CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548276181
- **Authorized official:** MATTHEW SIWICKI RPH (DIR OF PHCY)
- **Authorized official phone:** (304) 354-9244

## Contact information

- **Practice address:** 186 HOSPITAL DR, GRANTSVILLE, WV 26147-7100
- **Practice address phone:** (304) 354-9244
- **Practice address fax:** (304) 354-9323
- **Mailing address:** 186 HOSPITAL DR, GRANTSVILLE, WV 26147-7100
- **Mailing address phone:** (304) 354-9244
- **Mailing address fax:** (304) 354-9323

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0002X | Clinic Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336I0012X | Institutional Pharmacy | SP0552285 | WV | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 08/01/2006
- **Last updated:** 04/21/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000217600 | — | WV |
| 01 | — | 2109577 | PK | — |