Organization
GREENBRIER VMC LLC
Active
Other names
Greenbrier Valley Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA LALOR (DIRECTOR/DELEGATED OFFICIAL)
(629) 215-3953
Entity
Organization
Contact information
Practice address
1320 MAPLEWOOD AVE, RONCEVERTE, WV 24970-8016
(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
207L00000X
Anesthesiology Physician
—
—
282N00000X
General Acute Care Hospital
Primary
55
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010641000
—
WV
Enumeration date
05/23/2006
Last updated
04/01/2021
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