Organization
MEMORIAL HOSPITAL, INC.
Active
Other names
Mingo Wayne Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD BOGGESS (CFO)
(606) 598-5104
Entity
Organization
Contact information
Practice address
155 E 2ND AVE, WILLIAMSON, WV 25661-3601
(304) 235-3010
(304) 235-3014
Mailing address
PO BOX 445, WILLIAMSON, WV 25661-0445
(304) 235-3010
(304) 235-3014
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
150039
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0004862000
—
WV
Enumeration date
07/12/2006
Last updated
01/13/2021
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