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General NPI Number Information
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NPI Number | 1164459566
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Entity Type | Organization
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Legal Business Name | QUINWOOD EMERGENCY AMBULANCE INC
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 02/21/2011
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Provider Practice Location Address
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Address Line | 111 MCCLUNG ST
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City | QUINWOOD
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State | WV
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Zip | 25981-0253
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Country | US
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Telephone | 304-438-9252
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Fax | 304-438-7148
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Provider Business Mailing Address
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Address Line | PO BOX 253 111 MCCLUNG ST
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City | QUINWOOD
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State | WV
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Zip | 25981-0253
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Country | US
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Telephone | 304-438-9252
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Fax | 304-438-7148
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Authorized Official
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Title or Position | PT ACCOUNTS
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Name | MRS. SERENA J DAVIS
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Credential |
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Telephone | 304-438-9252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 31344
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License Number State | WV
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