MEDICARE: MASON COUNTY EMERGENCY AMBULANCE AUTHORITY

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	3416L0300X	Land Ambulance

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590013584	OTHER	WV	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	001705580	OTHER	WV	BLUE CROSS
3	080025800	OTHER	WV	BLACK LUNG
4	224644	OTHER	WV	CARELINK
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730355868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MASON COUNTY EMERGENCY AMBULANCE AUTHORITY

Provider Business Mailing Address
First Line	:	836 4TH AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-1407
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2309 JACKSON AVE
Second Line	:
City	:	POINT PLEASANT
State	:	WV
Zip	:	25550-2005
Country	:	US
Telephone Number	:	304-675-6134
Fax Number	:

Authorized Official
Title or Position	:	CHIEF
Name	:	CHECK BLAKE
Credential	:
Telephone Number	:	304-675-6134

Provider Enumeration Date	:	05/08/2008
Last Update Date	:	05/08/2008

Similar Medicare Providers

1528066511 — MASON COUNTY EMERGENCY AMBULANCE SERVICE AUTHORITY
Practice Location Address:

911 EMERGENCY DRIVE
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1922274059 — MASON COUNTY EMERGENCY AMBULANCE AUTHORITY
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1740297993 — DR. ANTONIO P REYES M.D.
Practice Location Address:

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Practice Location Address:

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Directions to “MASON COUNTY EMERGENCY AMBULANCE AUTHORITY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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