# BRAXTON COUNTY MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Braxton Community Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639278518
- **Authorized official:** KIMBERLY D KNIGHT (CFO)
- **Authorized official phone:** (304) 364-1128

## Contact information

- **Practice address:** 617 RIVER ST, GASSAWAY, WV 26624-1137
- **Practice address phone:** (304) 364-2401
- **Mailing address:** 100 HOYLMAN DR, GASSAWAY, WV 26624-9321
- **Mailing address phone:** (304) 364-1093

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 002 | WV | — |
| 261QR1300X | Rural Health Clinic/Center | 031428 | WV | Yes |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 07/21/2022