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General NPI Number Information
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NPI Number | 1992040398
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Entity Type | Organization
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Legal Business Name | GRANTTOWN EMERGENCY MEDICAL SERVICES INC
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Dates
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Enumeration Date | 12/11/2012
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 110 BALLAH AVE
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City | GRANT TOWN
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State | WV
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Zip | 26574-0024
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Country | US
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Telephone | 130-427-8777
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Fax | 304-278-7787
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Provider Business Mailing Address
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Address Line | PO BOX 24
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City | GRANT TOWN
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State | WV
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Zip | 26574-0024
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Country | US
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Telephone | 304-278-7777
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Fax | 304-278-7787
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Authorized Official
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Title or Position | ASSISTANT CHIEF
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Name | AMANDA NICOLE STOVER
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Credential | EMT, CAC
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Telephone | 304-278-7777
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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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