# WEIRTON AREA AMBULANCE & RESCUE SQUAD INC

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

## Provider details

- **NPI number:** 1790719631
- **Authorized official:** MRS. PENNY ANN BRICKER (MEDICARE MANAGER)
- **Authorized official phone:** (304) 797-1233

## Contact information

- **Practice address:** 1305 PENNSYLVANIA AVENUE, WEIRTON, WV 26062
- **Practice address phone:** (304) 797-1233
- **Practice address fax:** (304) 748-5445
- **Mailing address:** 1305 PENNSYLVANIA AVENUE, WEIRTON, WV 26062
- **Mailing address phone:** (304) 797-1233
- **Mailing address fax:** (304) 748-5445

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 341600000X | Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 07/10/2006
- **Last updated:** 02/02/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000213152 | MOUNTAIN STATE BLUE CROSS | WV |
| 05 | — | 014558700 | — | WV |
| 01 | — | 0300810 | OHIO DOW | OH |