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General NPI Number Information
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NPI Number | 1679573026
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Entity Type | Organization
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Legal Business Name | GRAFTON TAYLOR COUNTY BOARD OF HEALTH
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 01/31/2012
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Provider Practice Location Address
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Address Line | 718 W MAIN ST
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City | GRAFTON
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State | WV
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Zip | 26354-1157
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Country | US
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Telephone | 304-265-1288
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Fax | 304-265-5067
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Provider Business Mailing Address
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Address Line | PO BOX 15
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City | GRAFTON
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State | WV
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Zip | 26354-0015
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Country | US
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Telephone | 304-265-1288
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Fax | 304-265-5067
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Authorized Official
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Title or Position | ADMINISTRATIVE ASSISTANT
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Name | MRS. CRYSTAL M PETERS
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Credential |
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Telephone | 304-265-1288
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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 | 005036
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License Number State | WV
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