MEDICARE: MAYSVILLE VOLUNTEER FIRE COMPANY

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	3416L0300X	Land Ambulance
2	3416L0300X	Land Ambulance	WVEMS	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205169133
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAYSVILLE VOLUNTEER FIRE COMPANY

Provider Business Mailing Address
First Line	:	836 4TH AVENUE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701
Country	:	US
Telephone Number	:	800-676-4785
Fax Number	:	304-522-4222

Provider Business Practice Location Address
First Line	:	ROUTE 42
Second Line	:
City	:	MAYSVILLE
State	:	WV
Zip	:	26833
Country	:	US
Telephone Number	:	304-749-7731
Fax Number	:	304-749-8087

Authorized Official
Title or Position	:	PROVIDER RELATIONS SPECIALIST
Name	:	MIKE WHEELER
Credential	:
Telephone Number	:	800-676-4785

Provider Enumeration Date	:	09/10/2009
Last Update Date	:	03/11/2010

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Directions to “MAYSVILLE VOLUNTEER FIRE COMPANY ” Practice Location

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