Healthcare Provider Details

I. General information

NPI: 1720287675
Provider Name (Legal Business Name): WETZEL COUNTY EMERGENCY AMBULANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 05/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SCHOOL STREET
PINE GROVE WV
26419
US

IV. Provider business mailing address

836 4TH AVE
HUNTINGTON WV
25701-1407
US

V. Phone/Fax

Practice location:
  • Phone: 304-455-5931
  • Fax:
Mailing address:
  • Phone: 304-522-7533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberWV EMS
License Number StateWV

VIII. Authorized Official

Name: JANET MILLER
Title or Position: CHIEF
Credential:
Phone: 304-455-5931