Healthcare Provider Details

I. General information

NPI: 1952499527
Provider Name (Legal Business Name): KANAWHA-CHARLESTON HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 LEE ST E
CHARLESTON WV
25301-1506
US

IV. Provider business mailing address

PO BOX 927
CHARLESTON WV
25323-0927
US

V. Phone/Fax

Practice location:
  • Phone: 304-348-8080
  • Fax: 304-346-4756
Mailing address:
  • Phone: 304-348-8080
  • Fax: 304-346-4756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. DEANNA K BONHAM
Title or Position: OFFICE MANAGER
Credential: CMA
Phone: 304-348-8080