Organization
NORTHERN GREENBRIER AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS BOGGS (CHIEF)
(304) 497-4334
Entity
Organization
Contact information
Practice address
ROUTE 219 BOX 74, RENICK, WV 24966-0000
(304) 497-4334
Mailing address
836 4TH AVE, HUNTINGTON, WV 25701-0000
(304) 521-1576
(304) 521-1768
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001705371
BCBS
WV
05
—
0145418000
—
WV
01
—
080247600
BLACK LUNG
WV
01
—
224444
CARELINK
WV
01
—
55080796
TRICARE
WV
01
—
5508079600
OH WORKERS COMP
OH
01
—
5508079600
WV WORKERS COMP
WV
01
—
590011733
RR MEDICARE
WV
Enumeration date
07/14/2005
Last updated
10/19/2012
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