# TAYLOR COUNTY EMERGENCY SQUAD

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

## Provider details

- **NPI number:** 1770795353
- **Authorized official:** GAVIN WATKINS (DIRECTOR)
- **Authorized official phone:** (304) 265-0904

## Contact information

- **Practice address:** 797 GEORGE WASHINGTON HWY., GRAFTON, WV 26354
- **Practice address phone:** (304) 265-0904
- **Practice address fax:** (304) 265-0906
- **Mailing address:** PO BOX 161, GRAFTON, WV 26354
- **Mailing address phone:** (304) 265-0904
- **Mailing address fax:** (304) 265-0906

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | 54633 | WV | Yes |
| 341600000X | Ambulance | — | NULL | — |
| 341600000X | Ambulance | — | WV | — |
| 3416L0300X | Land Ambulance | — | NULL | — |

## Other

- **Enumeration date:** 05/04/2007
- **Last updated:** 08/01/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000207283 | MOUNTAIN STATE BCBS | WV |
| 05 | — | 0145530000 | — | WV |
| 01 | — | 0161950 | UMWA HEALTH RETIREMENT FU | WV |