Healthcare Provider Details

I. General information

NPI: 1952301764
Provider Name (Legal Business Name): ELK DISTRICT AMBULANCE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 03/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MAPLE STREET
ELK GARDEN WV
26717
US

IV. Provider business mailing address

836 4TH AVE
HUNTINGTON WV
25701-1407
US

V. Phone/Fax

Practice location:
  • Phone: 304-446-5519
  • Fax:
Mailing address:
  • Phone: 800-676-4785
  • Fax: 304-522-4222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ARTHUR D. WELCH
Title or Position: CAPTAIN
Credential:
Phone: 304-446-5519