| Organization Name: | BROADDUS HOSPITAL ASSOCIATION, INC. |
| NPI Number: | 1548246622 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY A. POWELSON (CEO) |
| Mailing Address: | #1 Healthcare Drive Mansfield Hill Philippi |
| State: | WV US |
| Postal Code: | 26416 |
| Phone Number: | 3044571760 |
| Fax Number: | 3044571516 |
| NPI Enumeration Date: | 12/20/2005 |
| NPI Last Update Date: | 11/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 282NC0060X |
| License Number: | 96 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | General Acute Care Hospital |
| Taxonomy Specialization: | Critical Access |
| Taxonomy Definition: | |