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General NPI Number Information
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NPI Number | 1295959799
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Entity Type | Organization
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Legal Business Name | INDEPENDENT FIRE COMPANY NO. 1 OF CHARLES TOWN WEST VIRGINIA
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 10/05/2012
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Provider Practice Location Address
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Address Line | 200 W. SECOND AVENUE
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City | RANSON
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State | WV
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Zip | 25438-1071
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Country | US
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Telephone | 304-725-2514
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Fax | 304-728-6006
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Provider Business Mailing Address
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Address Line | 836 4TH AVENUE
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City | HUNTINGTON
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State | WV
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Zip | 25701-1407
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Country | US
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Telephone | 304-521-1576
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Fax | 304-521-1768
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Authorized Official
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Title or Position | PROVIDER RELATIONS SPECIALIST
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Name | MIKE WHEELER
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Credential |
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Telephone | 304-521-1576
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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 |
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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 | WVEMS
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License Number State | WV
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