Organization
WESTERN MARYLAND HEALTH SYSTEM CORPORATION
Active
Parent organization
WESTERN MARYLAND HEALTH SYSTEM CORPORATION
Other names
WMHS Urgent Care Services - Hunt Club Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
WESTERN MARYLAND HEALTH SYSTEM CORPORATION
Authorized official
KIMBERLY S REPAC (SR VP CFO)
(240) 964-8003
Entity
Organization
Contact information
Practice address
45 HUNT CLUB DR, RIDGELEY, WV 26753-7567
(304) 726-4501
(304) 726-4051
Mailing address
45 HUNT CLUB DR, RIDGELEY, WV 26753-7567
(304) 726-4501
(304) 726-4051
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001304838
MT. STATE BC BS
WV
05
—
3810002358
—
WV
01
—
A05 LU39HU
CAREFIRST BC BS MARYLAND
MD
01
—
CN1324
RAILROAD MEDICARE
MD
01
—
E458
DC BC BS - BLUE CHOICE
DC
Enumeration date
09/26/2006
Last updated
10/02/2019
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