MEDICARE: WAYNE COUNTY HEALTH DEPARTMENT

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
1	251E00000X	Home Health Agency

Other Identifiers

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

General Provider Information

NPI Number	:	1548255458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAYNE COUNTY HEALTH DEPARTMENT

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	:	590 RAILROAD AVE
Second Line	:
City	:	WAYNE
State	:	WV
Zip	:	25570-9706
Country	:	US
Telephone Number	:	304-272-6761
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. MELVIN O PLYMALE II
Credential	:
Telephone Number	:	304-272-6761

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	08/30/2010

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Directions to “WAYNE COUNTY HEALTH DEPARTMENT ” Practice Location

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