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NPI Code Detail

MEDICARE: WAYNE CO HEALTH DEPT (RFTS)

MEDICARE: WAYNE CO HEALTH DEPT (RFTS)
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251K00000XPublic Health or Welfare Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003204256
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAYNE CO HEALTH DEPT (RFTS)
Provider Business Mailing Address
First Line : PO BOX 368
Second Line :
City : WAYNE
State : WV
Zip : 25570-0368
Country : US
Telephone Number : 304-272-6761
Fax Number : 304-272-6763
Provider Business Practice Location Address
First Line : 217 KENOVA AVE
Second Line :
City : WAYNE
State : WV
Zip : 25570-9795
Country : US
Telephone Number : 304-272-6761
Fax Number : 304-272-6763
Authorized Official
Title or Position : ADMINISTRATOR
Name : JOHN FIFE
Credential :
Telephone Number : 304-272-6761
Provider Enumeration Date : 12/22/2014
Last Update Date : 12/22/2014

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Directions to “WAYNE CO HEALTH DEPT (RFTS) ” Practice Location

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