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Organization
LOGAN GENERAL HOSPITAL LLC
Active
Organization
LOGAN GENERAL HOSPITAL LLC
Active
Other names
Logan Regional Medical Center - Rehabilitation Unit
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNETTA TRAYLOR (AO)
(502) 596-6063
Entity
Organization
Contact information
Practice address
20 HOSPITAL DR, LOGAN, WV 25601-3452
(304) 831-1101
(304) 831-1871
Mailing address
680 S 4TH ST, LOUISVILLE, KY 40202-2407
(502) 596-6063
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000307301
BLUE CROSS
WV
05
—
0102154000
—
WV
05
—
01690239
—
KY
05
—
0713697
—
OH
Enumeration date
05/17/2006
Last updated
06/26/2025
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