Healthcare Provider Details

I. General information

NPI: 1871784355
Provider Name (Legal Business Name): GILMER COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 MEDICAL DR SUITE #3
GLENVILLE WV
26351-1274
US

IV. Provider business mailing address

809 MEDICAL DR SUITE #3
GLENVILLE WV
26351-1274
US

V. Phone/Fax

Practice location:
  • Phone: 304-462-7351
  • Fax: 304-462-8956
Mailing address:
  • Phone: 304-462-7351
  • Fax: 304-462-8956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. CAROL ANNETTE BEAM
Title or Position: ADMINISTRATOR
Credential:
Phone: 304-462-7351