# WEST VIRGINIA UNIVERSITY PHYSICIAN OF CHARLESTON-VALLEY CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** WEST VIRGINIA UNIVERSITY PHYSICIANS OF CHARLESTON
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1790924454
- **Legal business name:** WEST VIRGINIA UNIVERSITY PHYSICIANS OF CHARLESTON
- **Authorized official:** ROBYN M MCDANIEL (PROVIDER RELATIONS SUPERVISOR)
- **Authorized official phone:** (304) 293-5033

## Contact information

- **Practice address:** 1000 LINCOLN DR, SOUTH CHARLESTON, WV 25309-2304
- **Practice address phone:** (304) 768-4410
- **Practice address fax:** (304) 768-4416
- **Mailing address:** PO BOX 7000, MORGANTOWN, WV 26507-7000
- **Mailing address phone:** (304) 293-7401
- **Mailing address fax:** (304) 293-6963

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 02/19/2009
- **Last updated:** 02/19/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4002106000 | — | WV |