Healthcare Provider Details

I. General information

NPI: 1912992157
Provider Name (Legal Business Name): RYNEAL FIRE COMPANY #1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 COMMERCE CIR STE 200
KEARNEYSVILLE WV
25430-4973
US

IV. Provider business mailing address

PO BOX 2501
MARTINSBURG WV
25402-2501
US

V. Phone/Fax

Practice location:
  • Phone: 304-263-2900
  • Fax: 304-263-6680
Mailing address:
  • Phone: 304-263-2900
  • Fax: 304-263-6680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. MARY J HELMICK
Title or Position: PRESIDENT
Credential:
Phone: 304-263-2900