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General NPI Number Information
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NPI Number | 1346249117
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Entity Type | Organization
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Legal Business Name | NORTHERN GREENBRIER AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | ROUTE 219 BOX 74
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City | RENICK
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State | WV
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Zip | 24966-0000
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Country | US
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Telephone | 304-497-4334
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Fax |
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Provider Business Mailing Address
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Address Line | 836 4TH AVE
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City | HUNTINGTON
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State | WV
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Zip | 25701-0000
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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 | CHIEF
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Name | CHRIS BOGGS
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Credential |
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Telephone | 304-497-4334
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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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