Healthcare Provider Details

I. General information

NPI: 1245327709
Provider Name (Legal Business Name): LEWIS COUNTY BOARD OF HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 COURT AVE
WESTON WV
26452-1915
US

IV. Provider business mailing address

125 COURT AVE
WESTON WV
26452-1915
US

V. Phone/Fax

Practice location:
  • Phone: 304-269-8218
  • Fax: 304-269-8220
Mailing address:
  • Phone: 304-269-8218
  • Fax: 304-269-8220

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. GENEVIEVE M RUBLE
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 304-269-8218