Organization
GRAFTON CITY HOSPITAL INC
Active
Other names
TYGART VALLEY TOTAL CARE CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY E LILLEY (ADMINISTRATOR)
(304) 265-0400
Entity
Organization
Contact information
Practice address
500 MARKET ST, GRAFTON, WV 26354-1184
(304) 265-0400
(304) 265-6417
Mailing address
500 MARKET ST, GRAFTON, WV 26354-1184
(304) 265-0400
(304) 265-6417
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
14
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0034632000
—
WV
Enumeration date
12/13/2006
Last updated
08/23/2010
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