Organization
STATE OF WEST VIRGINIA
Active
Other names
Jackie Withrow Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARLA JEAN PARENT (CHIEF FINANCIAL OFFICER)
(304) 256-6600
Entity
Organization
Contact information
Practice address
105 S EISENHOWER DR, BECKLEY, WV 25801-4929
(304) 256-6600
(304) 250-6554
Mailing address
105 S EISENHOWER DR, BECKLEY, WV 25801-4929
(304) 256-6600
(304) 250-6554
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
181
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003978000
—
WV
Enumeration date
08/16/2005
Last updated
02/05/2010
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