Provider Demographics
NPI:1619086741
Name:WEBSTER COUNTY BOARD OF HEALTH
Entity Type:Organization
Organization Name:WEBSTER COUNTY BOARD OF HEALTH
Other - Org Name:WEBSTER COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-847-5483
Mailing Address - Street 1:112 BELL ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:WEBSTER SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:26288-1196
Mailing Address - Country:US
Mailing Address - Phone:304-847-5483
Mailing Address - Fax:304-847-7692
Practice Address - Street 1:112 BELL ST
Practice Address - Street 2:SUITE C
Practice Address - City:WEBSTER SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:26288-1196
Practice Address - Country:US
Practice Address - Phone:304-847-5483
Practice Address - Fax:304-847-7692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVFV91882Medicare PIN