Organization
POTOMAC VALLEY HOSPITAL OF W VA , INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK G BOUCOT (PRESIDENT/CEO)
(304) 597-3510
Entity
Organization
Contact information
Practice address
537 S MINERAL ST, KEYSER, WV 26726-2936
(304) 788-1274
(304) 788-5154
Mailing address
100 PIN OAK LN, KEYSER, WV 26726-5908
(304) 597-3510
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/11/2024
Last updated
11/11/2024
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