Healthcare Provider Details

I. General information

NPI: 1548269582
Provider Name (Legal Business Name): TYLER COUNTY EMERGENCY SQUAD UNIT 3
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 09/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8856 MIDDLE ISLAND RD BOX 7
ALMA WV
26320-7201
US

IV. Provider business mailing address

836 4TH AVE
HUNTINGTON WV
25701-1407
US

V. Phone/Fax

Practice location:
  • Phone: 304-758-0519
  • Fax:
Mailing address:
  • Phone: 304-521-1576
  • Fax: 304-521-1768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateWV

VIII. Authorized Official

Name: ROSALIE KELLER
Title or Position: CHIEF
Credential:
Phone: 304-758-0519