Organization
WVU MEDICAL OFFICE BUILDING
Active
Parent organization
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
Authorized official
ANDREA RUMBLE (PROVIDER ENROLLMENT SPECIALIST)
(304) 293-5033
Entity
Organization
Contact information
Practice address
203 E 4TH AVE, RANSON, WV 25438-1617
(304) 293-7401
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 293-7401
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
51D1063492
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011526000
—
WV
Enumeration date
08/04/2011
Last updated
08/04/2011
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