Healthcare Provider Details

I. General information

NPI: 1528480712
Provider Name (Legal Business Name): NATIONAL EMERGENCY SERVICES WEST VIRGINIA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2014
Last Update Date: 01/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 HOSPITAL DR
PETERSBURG WV
26847-9566
US

IV. Provider business mailing address

PO BOX 742722
ATLANTA GA
30374-2722
US

V. Phone/Fax

Practice location:
  • Phone: 304-257-1026
  • Fax:
Mailing address:
  • Phone: 800-377-8721
  • Fax: 304-697-1155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER MOORE
Title or Position: CFO
Credential:
Phone: 415-435-4591