# SHAVERS FORK FIRE RESCUE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205836095
- **Authorized official:** BRANDON JONES (DIRECTOR OF EMS)
- **Authorized official phone:** (304) 661-8101

## Contact information

- **Practice address:** 150 RESCUE ROAD, SNOWSHOE, WV 26209
- **Practice address phone:** (304) 572-3473
- **Practice address fax:** (304) 572-2400
- **Mailing address:** PO BOX 388, SNOWSHOE, WV 26209-0388
- **Mailing address phone:** (304) 572-3473
- **Mailing address fax:** (304) 572-2400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | — | NULL | Yes |
| 3416L0300X | Land Ambulance | — | WV | — |

## Other

- **Enumeration date:** 07/22/2005
- **Last updated:** 05/30/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 001776953 | BLUE CROSS | WV |
| 01 | — | 263174 | CARELINK | WV |
| 05 | — | 3810002251 | — | WV |
| 01 | — | ========= | WV WORKERS COMP | WV |