MEDICARE: VALLEY GROVE VOLUNTEER FIRE DEPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	027014	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	=========	OTHER	OH	OHIO BWC
2	N7431271	OTHER		HEALTH PLAN OF UPPER OHIO
3	001705486	OTHER	WV	HIGHMARK BLUE SHIELD
4	=========	OTHER	WA	WV COMPENSATION
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	001705486	OTHER	WV	MOUNTAIN STATE BCBS

General Provider Information

NPI Number	:	1003913443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY GROVE VOLUNTEER FIRE DEPT

Provider Business Mailing Address
First Line	:	836 4TH AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-1407
Country	:	US
Telephone Number	:	304-521-1576
Fax Number	:	304-521-1576

Provider Business Practice Location Address
First Line	:	355 FIRE HOUSE LN
Second Line	:
City	:	VALLEY GROVE
State	:	WV
Zip	:	26060
Country	:	US
Telephone Number	:	304-547-0347
Fax Number	:	304-547-1085

Authorized Official
Title or Position	:	EMS DIRECTOR
Name	:	ALBERT BOND
Credential	:	RN, EMT-P
Telephone Number	:	304-547-0347

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	06/24/2024

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Directions to “VALLEY GROVE VOLUNTEER FIRE DEPT ” Practice Location

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