Organization
COUNTY OF GRANT
Active
Other names
GRANT COUNTY AMBULANCE
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY HOTTINGER (EMS DIRECTOR)
(681) 892-0246
Entity
Organization
Contact information
Practice address
117 VIRGINIA AVE, PETERSBURG, WV 26847-1713
(681) 592-0246
(681) 892-0248
Mailing address
836 4TH AVE, HUNTINGTON, WV 25701-1407
(304) 521-1576
(304) 521-1576
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
61206
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003710143
HIGHMARK BLUE SHIELD
WV
Enumeration date
09/18/2017
Last updated
04/22/2024
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