# MINNIE HAMILTON HEALTH CARE CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dental Office - Medicaid
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962519967
- **Authorized official:** MR. STEPHEN S. WHITED (CFO/COO)
- **Authorized official phone:** (304) 354-9244

## Contact information

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

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 150 | WV | Yes |

## Other

- **Enumeration date:** 08/24/2006
- **Last updated:** 04/18/2012