MEDICARE: HAMPSHIRE 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	251K00000X	Public Health or Welfare Agency	N/A	WV

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	:	1750489415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAMPSHIRE COUNTY BOARD OF HEALTH

Provider Business Mailing Address
First Line	:	HC 71 BOX 9
Second Line	:
City	:	AUGUSTA
State	:	WV
Zip	:	26704-9502
Country	:	US
Telephone Number	:	304-496-9641
Fax Number	:	304-496-9650

Provider Business Practice Location Address
First Line	:	HC 71 BOX 9
Second Line	:
City	:	AUGUSTA
State	:	WV
Zip	:	26704-9502
Country	:	US
Telephone Number	:	304-496-9641
Fax Number	:	304-496-9650

Authorized Official
Title or Position	:	CHAIRMAN OF THE BOARD
Name	:	MR. GAVIN HEARE
Credential	:
Telephone Number	:	304-822-3585

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

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