Healthcare Provider Details

I. General information

NPI: 1497855811
Provider Name (Legal Business Name): HARDY COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 10/22/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 SPRING AVE SUITE 101
MOOREFIELD WV
26836-1036
US

IV. Provider business mailing address

411 SPRING AVE SUITE 101
MOOREFIELD WV
26836-1036
US

V. Phone/Fax

Practice location:
  • Phone: 304-530-6355
  • Fax:
Mailing address:
  • Phone: 304-530-6355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. WILLIAM A. OURS
Title or Position: ADMINISTRATOR
Credential:
Phone: 304-530-6355