Provider Demographics
NPI:1043235914
Name:BOONE COUNTY HEALTH DEPT.
Entity Type:Organization
Organization Name:BOONE COUNTY HEALTH DEPT.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:Z
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RNCS,NP
Authorized Official - Phone:304-369-7967
Mailing Address - Street 1:PO BOX 209
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WV
Mailing Address - Zip Code:25130-0209
Mailing Address - Country:US
Mailing Address - Phone:304-369-7967
Mailing Address - Fax:304-369-2832
Practice Address - Street 1:213 KENMORE DRIVE
Practice Address - Street 2:LICK CREEK RD.
Practice Address - City:DANVILLE
Practice Address - State:WV
Practice Address - Zip Code:25053
Practice Address - Country:US
Practice Address - Phone:304-369-7967
Practice Address - Fax:304-369-2832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare