MEDICARE: WEST UNION VOLUNTEER LIFE SQUAD INC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000307857	OTHER	OH	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700999042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST UNION VOLUNTEER LIFE SQUAD INC

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	:

Provider Business Practice Location Address
First Line	:	215 E SPARKS ST
Second Line	:
City	:	WEST UNION
State	:	OH
Zip	:	45693-1036
Country	:	US
Telephone Number	:	937-544-3958
Fax Number	:

Authorized Official
Title or Position	:	EMS CHIEF
Name	:	JEFFREY MCCARTY
Credential	:
Telephone Number	:	937-544-3958

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	05/27/2016

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