Healthcare Provider Details

I. General information

NPI: 1952973604
Provider Name (Legal Business Name): MOUNT HOPE FIRE DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 07/13/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 MAIN ST
MOUNT HOPE WV
25880-1150
US

IV. Provider business mailing address

428 MAIN ST
MOUNT HOPE WV
25880-1150
US

V. Phone/Fax

Practice location:
  • Phone: 304-877-2488
  • Fax:
Mailing address:
  • Phone: 304-877-2488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. SHANE WILLIAM WHEELER
Title or Position: CHIEF
Credential:
Phone: 304-763-8279