# MASON COUNTY EMERGENCY AMBULANCE SERVICE AUTHORITY

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

## Provider details

- **NPI number:** 1528066511
- **Authorized official:** CHUCK BLAKE (CHIEF)
- **Authorized official phone:** (304) 675-6134

## Contact information

- **Practice address:** 911 EMERGENCY DRIVE, PT PLEASANT, WV 25550-2005
- **Practice address phone:** (304) 675-6134
- **Practice address fax:** (304) 675-7433
- **Mailing address:** 836 4TH AVE, HUNTINGTON, WV 25701-1407
- **Mailing address phone:** (800) 676-4785
- **Mailing address fax:** (304) 522-4222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | WV EMS | WV | Yes |

## Other

- **Enumeration date:** 07/13/2005
- **Last updated:** 10/17/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 001705580 | BLUE CROSS BLUE SHIELD | WV |
| 01 | — | 080025800 | BLACK LUNG | WV |
| 05 | — | 2196556 | — | OH |
| 01 | — | 590013584 | RAILROAD MEDICARE | WV |
| 05 | — | 9000056000 | — | WV |