Provider Demographics
NPI:1043497902
Name:BERKELEY -MORGAN COUNTY BOARD OF HEALTH
Entity Type:Organization
Organization Name:BERKELEY -MORGAN COUNTY BOARD OF HEALTH
Other - Org Name:MORGAN COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KEARNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-263-5131
Mailing Address - Street 1:137 WAR MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:BERKELEY SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:25411-1743
Mailing Address - Country:US
Mailing Address - Phone:304-258-1513
Mailing Address - Fax:304-258-6148
Practice Address - Street 1:137 WAR MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:BERKELEY SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:25411-1743
Practice Address - Country:US
Practice Address - Phone:304-258-1513
Practice Address - Fax:304-258-6148
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BERKELEY-MORGAN COUNTY BOARD OF HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV550690759Medicaid