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General NPI Number Information
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NPI Number | 1083588982
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Entity Type | Organization
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Legal Business Name | MOUNTAINEER RIDE CARE, INC.
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 207 N LEWIS ST
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City | GLENVILLE
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State | WV
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Zip | 26351-1224
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Country | US
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Telephone | 304-266-5228
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Fax | 304-266-5228
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Provider Business Mailing Address
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Address Line | 3524 US HIGHWAY 33 E
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City | GLENVILLE
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State | WV
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Zip | 26351-7078
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Country | US
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Telephone | 304-266-5228
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Fax | 304-266-5228
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. KYLE EDWARD WISE
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Credential |
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Telephone | 304-266-5228
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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