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General NPI Number Information
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NPI Number | 1205836095
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Entity Type | Organization
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Legal Business Name | SHAVERS FORK FIRE RESCUE INC
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 150 RESCUE ROAD
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City | SNOWSHOE
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State | WV
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Zip | 26209
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Country | US
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Telephone | 304-572-3473
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Fax | 304-572-2400
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Provider Business Mailing Address
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Address Line | PO BOX 388
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City | SNOWSHOE
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State | WV
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Zip | 26209-0388
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Country | US
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Telephone | 304-572-3473
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Fax | 304-572-2400
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Authorized Official
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Title or Position | DIRECTOR OF EMS
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Name | BRANDON JONES
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Credential |
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Telephone | 304-661-8101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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