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General NPI Number Information
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NPI Number | 1588810287
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Entity Type | Organization
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Legal Business Name | LOGAN COUNTY BOARD OF HEALTH
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Dates
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Enumeration Date | 08/13/2008
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 300 STRATTON ST ROOM 203
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City | LOGAN
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State | WV
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Zip | 25601-3924
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Country | US
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Telephone | 304-792-8630
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Fax | 304-792-8635
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Provider Business Mailing Address
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Address Line | 300 STRATTON ST ROOM 203
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City | LOGAN
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State | WV
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Zip | 25601-3924
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Country | US
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Telephone | 304-792-8630
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Fax | 304-792-8635
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Authorized Official
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Title or Position | HEALTH DIRECTOR
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Name | DR. LIVIA N CABAUATAN
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Credential | M.D.
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Telephone | 304-792-8630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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