Active NPI
County of Marion Board of Health
- State or Local Public Health Clinic/Center
- Fairmont, WV
National Provider Identifier
1124173935
On this page
Key facts
NPPES NPI Registry- Primary specialty
- State or Local Public Health Clinic/Center
- Legal business name
- COUNTY OF MARION BOARD OF HEALTH
- Practice address
- 300 2ND St
Fairmont, WV 26554-2830 - Phone
- (304) 366-3360
- Fax
- (304) 363-8217
- NPI assigned
- Jan 24, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Lloyd Ray White, MPH
- Title
- Administrator
- Phone
- (304) 366-3360
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| State or Local Public Health Clinic/Center | 261QP0905X | Primary |
Addresses
Primary practice location
300 2ND St
Fairmont, WV 26554-2830
Mailing address
300 2ND St
Fairmont, WV 26554-2830
Phone (304) 366-3360
Other names 1
- Marion County Health Department
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040326000473 | WV | Part B Supplier - Mass Immunization (Roster Biller Only) | 7618863903 | Practice locations: Fairmont, WV |
National Provider Directory
National Provider Directory- Tax ID family
- Marion County Health Department
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Public Health or Welfare Agency
- Fairmont, WV
- NPI 1679799076
-
- Home Health Agency
- Fairmont, WV
- NPI 1184622722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1363824000000",
"number": "1124173935",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 2ND ST",
"city": "FAIRMONT",
"state": "WV",
"postal_code": "265542830",
"telephone_number": "304-366-3360",
"fax_number": "304-363-8217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 2ND ST",
"city": "FAIRMONT",
"state": "WV",
"postal_code": "265542830",
"telephone_number": "304-366-3360",
"fax_number": "304-363-8217"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COUNTY OF MARION BOARD OF HEALTH",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-24",
"last_updated": "2013-03-21",
"status": "A",
"authorized_official_last_name": "WHITE",
"authorized_official_first_name": "LLOYD",
"authorized_official_middle_name": "RAY",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "304-366-3360",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "MPH"
},
"taxonomies": [
{
"code": "261QP0905X",
"taxonomy_group": "",
"desc": "Clinic/Center, Public Health, State or Local",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Marion County Health Department",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fairmont, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.