Provider Demographics
NPI:1013913607
Name:MARSHALL COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:MARSHALL COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING TECHNICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BECKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-845-7840
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:MOUNDSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26041-0429
Mailing Address - Country:US
Mailing Address - Phone:304-845-7840
Mailing Address - Fax:304-843-9837
Practice Address - Street 1:6TH STREET & COURT AVE
Practice Address - Street 2:
Practice Address - City:MOUNDSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26041-0429
Practice Address - Country:US
Practice Address - Phone:304-845-7840
Practice Address - Fax:304-843-9837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVHD327AOtherHEALTH PLAN
OH0920230Medicaid
WV=========001OtherBLUE CROSS BLUE SHIELD
WV=========001OtherBLUE CROSS BLUE SHIELD
OH0920230Medicaid