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Organization
COUNTY OF HARDY
Active
Organization
COUNTY OF HARDY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA A. STEWART (MEDICAID COORDINATOR)
(304) 267-3595
Entity
Organization
Contact information
Practice address
510 ASHBY ST., COUNTY OF HARDY, MOOREFIELD, WV 26836-1001
(304) 267-3595
(304) 267-3599
Mailing address
109 S. COLLEGE ST, MARTINSBURG, WV 25401
(304) 267-3595
(304) 267-3599
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0012246000
PROVIDER NUMBER
WV
Enumeration date
10/05/2007
Last updated
10/05/2007
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