Organization
QUINWOOD EMERGENCY AMBULANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SERENA J DAVIS (PT ACCOUNTS)
(304) 438-9252
Entity
Organization
Contact information
Practice address
111 MCCLUNG ST, QUINWOOD, WV 25981-0253
(304) 438-9252
(304) 438-7148
Mailing address
PO BOX 253, 111 MCCLUNG ST, QUINWOOD, WV 25981-0253
(304) 438-9252
(304) 438-7148
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
31344
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001704988
MT ST BCBS
WV
05
—
0145769000
—
WV
01
—
086795400
DEPT OF LABOR
WV
01
—
1141627
UMWA
WV
01
—
407590215
RAILROAD MEDICARE
WV
Enumeration date
06/28/2006
Last updated
02/21/2011
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