Provider Demographics
NPI:1144383498
Name:BOONE COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:BOONE COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRPERSON OF THE BOARD OF HEALTH
Authorized Official - Prefix:MRS
Authorized Official - First Name:ONA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-369-2488
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:
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:2006-12-18
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0021454000Medicaid
WV0021454002Medicaid
WV0021454001Medicaid
WVFV91121Medicare PIN
WV0021454001Medicaid