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CHARLESTON AREA MEDICAL CENTER
Complete NPI Record 1518164037
General Acute Care Hospital - Critical Access in Charleston, WV

NPI Status: Active since June 28, 2007

Contact Information

3110 MACCORKLE AVENUE SE
CHARLESTON, WV
ZIP 25304
Phone: (304) 347-1341

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider First Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Enumeration Date
  18. Last Update Date
  19. Authorized Official Last Name
  20. Authorized Official First Name
  21. Authorized Official Title or Position
  22. Authorized Official Telephone Number
  23. Healthcare Provider Taxonomy Code 1
  24. Healthcare Provider Primary Taxonomy Switch 1
  25. Is Organization Subpart
  26. Authorized Official Name Prefix Text
  27. Authorized Official Credential Text

Complete NPI Dataset

This page represents the complete record for NPI 1518164037. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1518164037
The city name in the location address of the provider being identified.
Entity Type Code: 2
The State code in the location of the provider being identified.
Employer Identification Number EIN: UNAVAIL
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
The country code in the location address of the provider being identified.
Provider First Line Business Mailing Address: 3000 STAUNTON AVE DUNLOP HALL APT 37
The telephone number associated with the location address of the provider being identified.
Provider Business Mailing Address City Name: CHARLESTON
The fax number associated with the location address of the provider being identified.
Provider Business Mailing Address State Name: WV
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Mailing Address Postal Code: 25304
The date that a record was last updated or changed.
Provider Business Mailing Address Country Code If outside U S : US
The code designating the provider’s gender if the provider is a person.
Provider Business Mailing Address Telephone Number: 3047417725
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider First Line Business Practice Location Address: 3110 MACCORKLE AVENUE SE
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: CHARLESTON
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: WV
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 25304
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3043471341
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/28/2007
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 8/22/2020
The date that a record was last updated or changed.
Authorized Official Last Name: CLARKE
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: GEORGERY
The first name of the authorized official.
Authorized Official Title or Position: PROGRAM DIRECTOR
The title or position of the authorized official.
Authorized Official Telephone Number: 3047411341
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 282NC0060X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Is Organization Subpart: N
Authorized Official Name Prefix Text: DR.
Authorized Official Credential Text: MD