Healthcare Provider Details

I. General information

NPI: 1790103687
Provider Name (Legal Business Name): TUCKER COUNTY HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2014
Last Update Date: 03/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 SUNNYSIDE LANE
PARSONS WV
26269
US

IV. Provider business mailing address

219 SUNNYSIDE LANE
PARSONS WV
26269
US

V. Phone/Fax

Practice location:
  • Phone: 304-478-3572
  • Fax: 304-478-3864
Mailing address:
  • Phone: 304-478-3572
  • Fax: 304-478-3864

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: JAMES SNYDER
Title or Position: ADMINISTRATOR
Credential:
Phone: 304-478-3572