MEDICARE: WEBSTER COUNTY BOARD OF HEALTH

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	261QP0905X	State or Local Public Health Clinic/Center

General Provider Information

NPI Number	:	1619086741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEBSTER COUNTY BOARD OF HEALTH

Provider Business Mailing Address
First Line	:	112 BELL ST
Second Line	:	SUITE C
City	:	WEBSTER SPRINGS
State	:	WV
Zip	:	26288-1196
Country	:	US
Telephone Number	:	304-847-5483
Fax Number	:	304-847-7692

Provider Business Practice Location Address
First Line	:	112 BELL ST
Second Line	:	SUITE C
City	:	WEBSTER SPRINGS
State	:	WV
Zip	:	26288-1196
Country	:	US
Telephone Number	:	304-847-5483
Fax Number	:	304-847-7692

Authorized Official
Title or Position	:	OFFICE ASSISTANT
Name	:	MRS. SANDRA JEAN COCHRAN
Credential	:
Telephone Number	:	304-847-5483

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	02/20/2015

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Directions to “WEBSTER COUNTY BOARD OF HEALTH ” Practice Location

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