Provider Demographics
NPI:1952499527
Name:KANAWHA-CHARLESTON HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:KANAWHA-CHARLESTON HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MEADOWS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:304-348-8080
Mailing Address - Street 1:PO BOX 927
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25323-0927
Mailing Address - Country:US
Mailing Address - Phone:304-348-6494
Mailing Address - Fax:304-348-6821
Practice Address - Street 1:108 LEE ST E
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1506
Practice Address - Country:US
Practice Address - Phone:304-348-8080
Practice Address - Fax:304-346-4756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2083P0901X, 251K00000X
WV251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251K00000XAgenciesPublic Health or WelfareGroup - Multi-Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0021340003Medicaid
WV0021340003Medicaid
051519214Medicare PIN