Provider Demographics
NPI:1205932472
Name:HARRISON-CLARKSBURG HEALTH DEPARTMENT
Entity type:Organization
Organization Name:HARRISON-CLARKSBURG HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:BUNDY
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:304-623-9308
Mailing Address - Street 1:330 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-2910
Mailing Address - Country:US
Mailing Address - Phone:304-623-9308
Mailing Address - Fax:304-623-9364
Practice Address - Street 1:330 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-2910
Practice Address - Country:US
Practice Address - Phone:304-623-9308
Practice Address - Fax:304-623-9364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare