Healthcare Provider Details

I. General information

NPI: 1467119719
Provider Name (Legal Business Name): PRIORITY MEDICAL CLAIMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 11/22/2021
Certification Date: 11/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 GEORGE ST STE D
BECKLEY WV
25801-2648
US

IV. Provider business mailing address

PO BOX 911
MABSCOTT WV
25871-0911
US

V. Phone/Fax

Practice location:
  • Phone: 304-253-1059
  • Fax:
Mailing address:
  • Phone: 304-253-1059
  • Fax: 304-253-1965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: KEITH ALLEN WAYCASTER
Title or Position: PRESIDENT
Credential:
Phone: 304-253-1059