Organization
FORK RIDGE COMMUNITY VOLUNTEER FIRE
Active
Other names
Fork Ridge VFD
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE WHEELER (PROVIDER RELATIONS SPECIALIST)
(304) 521-1576
Entity
Organization
Contact information
Practice address
354 SAWMILL LN, GLEN EASTON, WV 26039-1547
(304) 845-3990
Mailing address
836 4TH AVE, HUNTINGTON, WV 25701-1407
(304) 521-1576
(304) 521-1768
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
WV0EMS
WV
341600000X
Ambulance
—
WV
3416L0300X
Land Ambulance
Primary
WV0EMS
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001705594
BLUE CROSS
WV
01
—
225257
CARELINK
WV
05
—
2516601
—
OH
01
—
590014570
RAILROAD MEDICARE
WV
05
—
8002019000
—
WV
Enumeration date
07/14/2005
Last updated
06/03/2015
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