Healthcare Provider Details

I. General information

NPI: 1972609592
Provider Name (Legal Business Name): DALLAS VFD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 06/17/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7024 DALLAS PIKE
DALLAS WV
26036
US

IV. Provider business mailing address

836 4TH AVENUE
HUNTINGTON WV
25701-1407
US

V. Phone/Fax

Practice location:
  • Phone: 304-547-4999
  • Fax:
Mailing address:
  • Phone: 304-521-1576
  • Fax: 304-521-1768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateWV

VIII. Authorized Official

Name: PHILLIP SCOTT ULLOM
Title or Position: EMS CHIEF
Credential:
Phone: 304-547-4999