Healthcare Provider Details

I. General information

NPI: 1457351249
Provider Name (Legal Business Name): WESTON LEWIS COUNTY EMERGENCY AMBULANCE SERVICE AUTHORITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 02/22/2023
Certification Date: 02/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 WEST 2ND ST
WESTON WV
26452-1665
US

IV. Provider business mailing address

836 4TH AVE
HUNTINGTON WV
25701-1407
US

V. Phone/Fax

Practice location:
  • Phone: 304-269-8207
  • Fax: 304-269-8208
Mailing address:
  • Phone: 304-521-1576
  • Fax: 304-521-1576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JAMES C TAYLOR
Title or Position: COORDINATOR
Credential:
Phone: 304-269-8207