Organization
GREENBRIER VMC LLC
Active
Other names
Greenbrier Valley Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA HURLEY (SENIOR VICE PRESIDENT)
(214) 473-3993
Entity
Organization
Contact information
Practice address
202 MAPLEWOOD AVE, RONCEVERTE, WV 24970-1334
(304) 647-4411
(304) 647-6010
Mailing address
13662 COLLECTION CENTER DR, CHICAGO, IL 60693-0136
(304) 647-4411
(304) 647-6010
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
WV
Enumeration date
05/24/2007
Last updated
09/11/2025
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