GRANT MEMORIAL HOSPITAL (NPI# 1265623094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265623094 |
| Entity Type | Organization |
| Organization Name | GRANT MEMORIAL HOSPITAL |
| Other Organization Name | GRANT MEMORIAL HOSPITAL |
| Practice Address |
117 Hospital Dr Petersburg WV 26847-9566 |
| Mailing Address |
117 Hospital Dr Po Box 1019 Petersburg WV 26847-9566 |
| Practice Telephone | 3042571026 |
| Practice Fax Number | 3042579622 |
| Mailing Telephone | 3042571026 |
| Mailing Fax Number | 3042579622 |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2017-02-16 |
| Authorized Official Name | BRENTON HARMAN (PIC) |
| Authorized Official Telephone | 3042571026 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| Y | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
IP0550877 | WV | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2109651 | 01 |
| Other Name | Type Code |
|---|---|
| GRANT MEMORIAL HOSPITAL | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275750234 | Grant Memorial Hospital | Durable Medical Equipment & Medical Supplies | Route 4 & 28, Petersburg, WV 26847-1019 | 2007-04-19 |
| 1396744108 | Grant Memorial Hospital | Clinic/Center | Hospital Drive, Petersburg, WV 26847 | 2005-07-14 |
| 1821096637 | Grant Memorial Hospital | Clinic/Center | State Route 55w, Mt Storm, WV 26739 | 2005-07-14 |
| 1356349161 | Grant Memorial Hospital | Clinic/Center | 1 Hospital Drive, Petersburg, WV 26847 | 2005-07-14 |
| 1245238237 | Grant Memorial Hospital | Clinic/Center | 8 Lee St, Suite 3, Moorefield, WV 26836-1091 | 2005-07-13 |
| 1346248283 | Grant Memorial Hospital | Clinic/Center | 10 Valley View St, Suite 101, Petersburg, WV 26847-9543 | 2005-07-13 |
| 1598763666 | Grant Memorial Hospital | Medicare Defined Swing Bed Unit | 117 Hospital Dr, Petersburg, WV 26847-9566 | 2005-07-12 |
| 1427579424 | Grant Memorial Hospital | Obstetrics & Gynecology | 65 Hospital Dr Ste 104, Petersburg, WV 26847-9549 | 2017-06-29 |
| 1316329121 | Grant Memorial Hospital | Internal Medicine | 117 Hospital Dr, Petersburg, WV 26847-9566 | 2015-06-29 |
| 1972983393 | Grant Memorial Hospital | Specialist | 65 Hospital Dr Ste 103, Petersburg, WV 26847-9549 | 2015-06-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | GRANT MEMORIAL HOSPITAL | 117 Hospital Dr, Petersburg, WV 26847-9566 |
| Street Address |
117 HOSPITAL DR |
| City | PETERSBURG |
| State | WV |
| Zip Code | 26847-9566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598763666 | Grant Memorial Hospital | Medicare Defined Swing Bed Unit | 117 Hospital Dr, Petersburg, WV 26847-9566 | 2005-07-12 |
| 1730565128 | Tri-county Emergency Physicians LLC | Emergency Medicine | 117 Hospital Dr, Petersburg, WV 26847-9566 | 2015-08-07 |
| 1316329121 | Grant Memorial Hospital | Internal Medicine | 117 Hospital Dr, Petersburg, WV 26847-9566 | 2015-06-29 |
| 1699181859 | Grant Memorial Hospital | Health Educator | 117 Hospital Dr, Petersburg, WV 26847-9566 | 2014-07-09 |
| 1528480712 | National Emergency Services West Virginia Inc | Emergency Medicine | 117 Hospital Dr, Petersburg, WV 26847-9566 | 2014-01-08 |
| 1659711455 | Matthew Shannon Johnson | Emergency Medicine | 117 Hospital Dr, Petersburg, WV 26847-9566 | 2013-06-26 |
| 1598055642 | Sharita Nicolle Johnson | Emergency Medicine | 117 Hospital Dr, Petersburg, WV 26847-9566 | 2011-04-11 |
| 1073786158 | John R Fischer | Emergency Medicine | 117 Hospital Dr, Petersburg, WV 26847-9566 | 2008-04-09 |
| 1598962193 | Peter Gregory Baltusnik | Emergency Medicine | 117 Hospital Dr, Petersburg, WV 26847 | 2007-06-28 |
| 1902841539 | Khaled Fathy Said | Emergency Medicine | 117 Hospital Dr, Petersburg, WV 26847-9566 | 2006-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720688419 | Kimberly Dawn Runion | Technician | 791 Cave Mtn Rd, Petersburg, WV 26847 | 2020-10-30 |
| 1417568445 | Sandra Shook | Technician | 145 Army Lane, Petersburg, WV 26847 | 2020-08-13 |
| 1023590874 | Milas Robertson | Registered Nurse | 117 Hospital Drive, Petersbirg, WV 26847 | 2018-08-29 |
| 1043723851 | Cathy Lynn Arbogast | Technician | 6114 Rig Road, Rig, WV 26847 | 2017-11-15 |
| 1497028500 | Fort Ashby Business Associates, Inc. | Hearing Aid Equipment | 141 Water Street, Moorefield, WV 26847 | 2012-02-21 |
| 1770856882 | Fort Ashby Business Associates, Inc | Durable Medical Equipment & Medical Supplies | 1045 North Fork Highway, Petersburg, WV 26847 | 2012-02-21 |
| 1518278118 | Amanda Marie Borror | Obstetrics & Gynecology | 65 Hospital Dr Ste 104, Petersburg, WV 26847 | 2010-06-29 |
| 1700055365 | Grant County Board of Education | Local Education Agency (LEA) | 204 Jefferson Avenue, Grant County Board of Education, Petersburg, WV 26847 | 2008-02-27 |
| 1679741664 | Andrea D Brogan | Speech-Language Pathologist | Grant County Board of Education, 204 Jefferson Avenue, Petersburg, WV 26847 | 2008-02-13 |
| 1538347943 | Larry C. Rogers | Family Medicine | Memorial Dr, Petersburg, WV 26847 | 2008-02-07 |
| Find all providers in zip 26847 | ||||
| Taxonomy Code | 3336I0012X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Institutional Pharmacy |
| A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033484886 | Federal Correctional Institute | Pharmacy | 446 Greenbag Rd, Morgantown, WV 26501-7159 | 2012-03-13 |
| 1467762351 | Fci Beckley | Pharmacy | 1600 Industrial Park Rd, Beaver, WV 25813-9529 | 2010-10-14 |
| 1104254440 | Ohio Valley Medical Center Inc | Pharmacy | 2000 Eoff St, Wheeling, WV 26003-3823 | 2013-10-24 |
| 1619019437 | Beckley Appalachian Reg Hosp | Pharmacy | 306 Stanaford Rd, Beckley, WV 25801-3142 | 2007-02-12 |
| 1750326880 | Wetzel County Hospital Association | Pharmacy | 3 East Benjamin Drive, New Martinsville, WV 26155-2705 | 2006-06-20 |
| 1568406254 | Wheeling Hospital, Inc. | Pharmacy | 1 Medical Park, Pharmacy, Wheeling, WV 26003-6379 | 2006-06-15 |
| 1639135221 | Boone Memorial Hospital Inc | Pharmacy | 701 Madison Ave, Madison, WV 25130-1669 | 2006-04-24 |
| City | PETERSBURG |
| Zip Code | 26847 |
Please comment or provide details below to improve the information on GRANT MEMORIAL HOSPITAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.