Organization
STONEWALL JACKSON MEMORIAL HOSPITAL
Active
Other names
STONEWALL JACKSON HOME CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. M. JANE EISENBEIS RN (DIRECTOR OF EXTERNAL OPERATIONS)
(304) 269-4556
Entity
Organization
Contact information
Practice address
456 SUITE B MARKET PLACE MALL, WESTON, WV 26452-6938
(304) 269-4556
(304) 269-4559
Mailing address
456 SUITE B MARKET PLACE MALL, WESTON, WV 26452-6938
(304) 269-4556
(304) 269-4559
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001417001
—
WV
01
—
300699
FEDERAL BLACK LUNG
WV
01
—
WV22958A
HEALTH PLAN
WV
Enumeration date
05/24/2005
Last updated
07/21/2022
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