- Enrollment id
- O20170413002452
- Enrollment state
- WV
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1922009505
- Multiple npi flag
- N
- Ccn
- 517118
- Associate id
- 6709771827
- Organization name
- WEIRTON MEDICAL CENTER INC
- Doing business as name
- WEST VIRGINIA UNIVERSITY HEALTH SYSTEM
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- N
- Address line 1
- 601 COLLIERS WAY
- City
- WEIRTON
- State
- WV
- Zip code
- 260625014