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General NPI Number Information
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NPI Number | 1063419315
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Entity Type | Organization
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Legal Business Name | DODDRIDGE COUNTY BOARD OF HEALTH
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 04/22/2021
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Provider Practice Location Address
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Address Line | 60 PENNSYLVANIA ST
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City | WEST UNION
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State | WV
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Zip | 26456-8143
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Country | US
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Telephone | 304-873-1531
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Fax |
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Provider Business Mailing Address
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Address Line | 60 PENNSYLVANIA ST
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City | WEST UNION
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State | WV
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Zip | 26456-8143
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Country | US
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Telephone | 304-873-1531
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DEBRA LYNNE DAVIS
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Credential |
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Telephone | 304-873-1531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 008845
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License Number State | WV
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