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General NPI Number Information
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NPI Number | 1770795353
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Entity Type | Organization
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Legal Business Name | TAYLOR COUNTY EMERGENCY SQUAD
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/01/2023
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Provider Practice Location Address
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Address Line | 797 GEORGE WASHINGTON HWY.
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City | GRAFTON
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State | WV
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Zip | 26354
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Country | US
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Telephone | 304-265-0904
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Fax | 304-265-0906
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Provider Business Mailing Address
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Address Line | PO BOX 161
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City | GRAFTON
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State | WV
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Zip | 26354
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Country | US
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Telephone | 304-265-0904
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Fax | 304-265-0906
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Authorized Official
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Title or Position | DIRECTOR
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Name | GAVIN WATKINS
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Credential |
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Telephone | 304-265-0904
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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 |
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License Number State |
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Taxonomy #3
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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 |
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Taxonomy #4
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 54633
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License Number State | WV
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