MEDICARE: MORGAN COUNTY RESCUE SERVICE 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	049620	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922038215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MORGAN COUNTY RESCUE SERVICE INC

Provider Business Mailing Address
First Line	:	1258 VALLEY RD
Second Line	:
City	:	BERKELEY SPRINGS
State	:	WV
Zip	:	25411-4800
Country	:	US
Telephone Number	:	304-258-4594
Fax Number	:	304-258-6218

Provider Business Practice Location Address
First Line	:	1258 VALLEY RD
Second Line	:
City	:	BERKELEY SPRINGS
State	:	WV
Zip	:	25411-4800
Country	:	US
Telephone Number	:	304-258-4594
Fax Number	:	304-258-6218

Authorized Official
Title or Position	:	FINANCIAL/PERSONNEL DIRECTOR
Name	:	RENEA M STANSBURY
Credential	:
Telephone Number	:	304-258-4594

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	07/26/2016

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