MEDICARE: WIRT COUNTY EMERGENCY 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		WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	590029286	OTHER	WV	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001704972	OTHER	WV	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	223296	OTHER	WV	CARELINK

General Provider Information

NPI Number	:	1871593624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WIRT COUNTY EMERGENCY SQUAD, INC

Provider Business Mailing Address
First Line	:	836 4TH AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-1407
Country	:	US
Telephone Number	:	800-676-4785
Fax Number	:	304-522-4222

Provider Business Practice Location Address
First Line	:	ROUTE 14 SOUTH
Second Line	:
City	:	ELIZABETH
State	:	WV
Zip	:	26143
Country	:	US
Telephone Number	:	304-275-4219
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEVEN SALSBURY SR.
Credential	:
Telephone Number	:	304-275-4219

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	03/05/2012

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Directions to “WIRT COUNTY EMERGENCY SQUAD, INC ” Practice Location

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