Provider Demographics
NPI:1790786200
Name:BARBOUR COUNTY BOARD OF HEALTH BARBOUR COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:BARBOUR COUNTY BOARD OF HEALTH BARBOUR COUNTY HEALTH DEPARTMENT
Other - Org Name:BARBOUR COUNTY HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF HOME HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:KERNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-457-3315
Mailing Address - Street 1:109 WABASH AVENUE
Mailing Address - Street 2:
Mailing Address - City:PHILIPPI
Mailing Address - State:WV
Mailing Address - Zip Code:26416-0019
Mailing Address - Country:US
Mailing Address - Phone:304-457-3315
Mailing Address - Fax:304-457-1296
Practice Address - Street 1:109 WABASH AVENUE
Practice Address - Street 2:
Practice Address - City:PHILIPPI
Practice Address - State:WV
Practice Address - Zip Code:26416-0019
Practice Address - Country:US
Practice Address - Phone:304-457-3315
Practice Address - Fax:304-457-1296
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BARBOUR COUNTY BOARD OF HEALTH BARBOUR COUNTY HELATH DEPART
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0021197001Medicaid
WV000324476OtherMT ST BLUE CR BLUE SHLD
WV1026259OtherBRICKSTREET MUT. INS CO.
WV000324476OtherMT ST BLUE CR BLUE SHLD