Healthcare Provider Details

I. General information

NPI: 1114964954
Provider Name (Legal Business Name): NICHOLAS COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 STEVENS RD STE 201
SUMMERSVILLE WV
26651-9704
US

IV. Provider business mailing address

1 STEVENS RD STE 201
SUMMERSVILLE WV
26651-9704
US

V. Phone/Fax

Practice location:
  • Phone: 304-872-5329
  • Fax: 304-872-5362
Mailing address:
  • Phone: 304-872-5329
  • Fax: 304-872-5362

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: ANITA R. STEWART
Title or Position: HEALTH OFFICER
Credential: DO
Phone: 304-872-5329