Organization
UNITED HOSPITAL CENTER
Active
Organization
UNITED HOSPITAL CENTER
Active
Parent organization
UNITED HOSPITAL CENTER, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNITED HOSPITAL CENTER, INC
Authorized official
MICHAEL TILLMAN (CEO)
(681) 342-1000
Entity
Organization
Contact information
Practice address
710 GENESIS BLVD, BRIDGEPORT, WV 26330-9668
(681) 342-3490
(681) 342-3491
Mailing address
527 MEDICAL PARK DR STE 400, BRIDGEPORT, WV 26330-9010
(681) 342-3500
(681) 342-3507
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
WV107
WV
207RR0500X
Rheumatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001709473
BLUE CROSS PAY TO NUMBER
WV
05
—
3810008622
—
WV
Enumeration date
10/23/2006
Last updated
11/01/2017
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