Organization
MASON COUNTY EMERGENCY AMBULANCE AUTHORITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHUCK BLAKE (CHIEF)
(304) 675-6134
Entity
Organization
Contact information
Practice address
239 JACKSON AVENUE, PT PLEASANT, WV 25550
(304) 675-6134
Mailing address
836 4TH AVE, HUNTINGTON, WV 25701-1407
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001705580
BLUE CROSS
WV
01
—
080025800
BLACK LUNG
WV
05
—
2196556
—
OH
01
—
224644
CARELINK
WV
01
—
590013584
RAILROAD MEDICARE
WV
05
—
9000056000
—
WV
Enumeration date
05/08/2008
Last updated
05/08/2008
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