Organization
FORK RIDGE COMMUNITY VOLUNTEER FIRE
Active
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
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
Update your record
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