Healthcare Provider Details

I. General information

NPI: 1427238583
Provider Name (Legal Business Name): WETZEL COUNTY BOARD OF EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 11/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 FOUNDRY ST
NEW MARTINSVILLE WV
26155-1142
US

IV. Provider business mailing address

333 FOUNDRY ST
NEW MARTINSVILLE WV
26155-1142
US

V. Phone/Fax

Practice location:
  • Phone: 304-231-3820
  • Fax:
Mailing address:
  • Phone: 304-231-3820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number StateWV

VIII. Authorized Official

Name: KAREN WOJCIK
Title or Position: MEDICAID SPECIALIST
Credential:
Phone: 304-231-3820