Provider Demographics
NPI:1922416650
Name:MCDOWELL COUNTY HEALTH UNIT
Entity Type:Organization
Organization Name:MCDOWELL COUNTY HEALTH UNIT
Other - Org Name:MCDOWELL COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:304-448-2174
Mailing Address - Street 1:PO BOX 218
Mailing Address - Street 2:
Mailing Address - City:WILCOE
Mailing Address - State:WV
Mailing Address - Zip Code:24895-0218
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:RTE. 103
Practice Address - Street 2:
Practice Address - City:WILCOE
Practice Address - State:WV
Practice Address - Zip Code:24895
Practice Address - Country:US
Practice Address - Phone:304-448-2174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
Provider Identifiers
StateIdentifier IDID TypeIssuer
FV90451Medicare UPIN