# TUCKER COUNTY AMBULANCE AUTHORITY

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

## Provider details

- **NPI number:** 1689877003
- **Authorized official:** SHEILA A. MAVSH (DIRECTOR)
- **Authorized official phone:** (304) 478-2296

## Contact information

- **Practice address:** 213 FIRST STREET, PARSONS, WV 26287-1046
- **Practice address phone:** (304) 478-2296
- **Mailing address:** PO BOX 129, BUCKHANNON, WV 26201-0129
- **Mailing address phone:** (304) 473-8988
- **Mailing address fax:** (304) 206-3141

## Taxonomy

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

## Other

- **Enumeration date:** 06/06/2007
- **Last updated:** 12/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000226451 | BLUE CROSS | WV |
| 01 | — | 002016693 | BCBS | WV |
| 05 | — | 01423631 | — | VA |
| 05 | — | 0145548000 | — | WV |
| 01 | — | 550559327 | UMWA | WV |
| 01 | — | 55055932700 | WV WORKERS COMP | WV |
| 01 | — | 590029302 | RR MEDICARE | WV |
| 01 | — | 813343 | BLACK LUNG | WV |