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General NPI Number Information
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NPI Number | 1124173935
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Entity Type | Organization
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Legal Business Name | COUNTY OF MARION BOARD OF HEALTH
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 03/21/2013
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Provider Practice Location Address
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Address Line | 300 2ND ST
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City | FAIRMONT
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State | WV
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Zip | 26554-2830
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Country | US
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Telephone | 304-366-3360
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Fax | 304-363-8217
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Provider Business Mailing Address
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Address Line | 300 2ND ST
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City | FAIRMONT
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State | WV
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Zip | 26554-2830
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Country | US
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Telephone | 304-366-3360
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Fax | 304-363-8217
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. LLOYD RAY WHITE
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Credential | MPH
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Telephone | 304-366-3360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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