MEDICARE: FRALEY AMBULANCE SERVICE

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		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	:	1386670701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRALEY AMBULANCE SERVICE

Provider Business Mailing Address
First Line	:	106 WASHINGTON ST
Second Line	:
City	:	MOOREFIELD
State	:	WV
Zip	:	26836-1139
Country	:	US
Telephone Number	:	304-530-0076
Fax Number	:	304-530-2056

Provider Business Practice Location Address
First Line	:	106 WASHINGTON ST
Second Line	:
City	:	MOOREFIELD
State	:	WV
Zip	:	26836-1139
Country	:	US
Telephone Number	:	304-530-0076
Fax Number	:	304-530-2056

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. PATTIE M FRALEY
Credential	:
Telephone Number	:	304-530-0076

Provider Enumeration Date	:	06/25/2006
Last Update Date	:	08/22/2020

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Directions to “FRALEY AMBULANCE SERVICE ” Practice Location

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