# GRANT MEMORIAL HOSPITAL

> 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:** Grant Memorial Hospital Family Medicine Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669885158
- **Authorized official:** MR. ROBERT W MILVET JR. (CEO)
- **Authorized official phone:** (305) 257-5800

## Contact information

- **Practice address:** 65 HOSPITAL DR, SUITE 106, PETERSBURG, WV 26847-9549
- **Practice address phone:** (304) 257-4511
- **Practice address fax:** (304) 257-4511
- **Mailing address:** PO BOX 1019, PETERSBURG, WV 26847-1019
- **Mailing address phone:** (304) 257-4511
- **Mailing address fax:** (304) 257-4511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 21 | WV | Yes |

## Other

- **Enumeration date:** 06/03/2014
- **Last updated:** 03/07/2019