| Organization Name: | RAINELLE MEDICAL CENTER, INC. |
| NPI Number: | 1093199036 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBRA J BENNETT (CREDENTIALING SPECIALIST) |
| Mailing Address: | 176 Medical Center Dr Rainelle |
| State: | WV US |
| Postal Code: | 259621064 |
| Phone Number: | 3044386188 |
| Fax Number: | 3044386819 |
| NPI Enumeration Date: | 07/18/2015 |
| NPI Last Update Date: | 07/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |