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Organization
LAVALETTE VOLUNTEER FIRE DEPT
Active
Organization
LAVALETTE VOLUNTEER FIRE DEPT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE WHEELER (PROVIDER RELATIONS SPECIALIST)
(304) 522-7533
Entity
Organization
Contact information
Practice address
4502 ROUTE 152, LAVALETTE, WV 25535
(304) 525-7156
(304) 525-2829
Mailing address
836 4TH AVENUE, HUNTINGTON, WV 25701
(304) 522-7533
(304) 522-4222
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
WV
3416L0300X
Land Ambulance
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0145904000
—
WV
01
—
590013929
RAILROAD MEDICARE
WV
Enumeration date
01/30/2007
Last updated
12/01/2010
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