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General NPI Number Information
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NPI Number | 1275690737
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Entity Type | Organization
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Legal Business Name | KANAWHA COUNTY EMERGENCY AMBULANCE AUTHORITY
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 601 BROOKS ST
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City | CHARLESTON
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State | WV
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Zip | 25301-1319
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Country | US
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Telephone | 304-345-2312
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Fax | 304-352-5316
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Provider Business Mailing Address
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Address Line | 601 BROOKS ST
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City | CHARLESTON
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State | WV
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Zip | 25301-1319
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Country | US
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Telephone | 304-345-2312
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Fax | 304-352-5316
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Authorized Official
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Title or Position | EXECUTIVE DIR, CHIEF OF MED SERVICE
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Name | MONICA LEAH MASON
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Credential | FNP
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Telephone | 304-345-2312
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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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