Provider Demographics
NPI:1659471076
Name:WYOMING COUNTY HEALTH DEPT.
Entity Type:Organization
Organization Name:WYOMING COUNTY HEALTH DEPT.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:FRED
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:RS
Authorized Official - Phone:304-732-7941
Mailing Address - Street 1:BANK & CEDAR ST
Mailing Address - Street 2:P O BOX 1679
Mailing Address - City:PINEVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:24874-1679
Mailing Address - Country:US
Mailing Address - Phone:304-732-7941
Mailing Address - Fax:304-732-6709
Practice Address - Street 1:BANK & CEDAR ST
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:WV
Practice Address - Zip Code:24874-1679
Practice Address - Country:US
Practice Address - Phone:304-732-7941
Practice Address - Fax:304-732-6709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0021483002Medicaid