Organization
CRAIG COUNTY - PAINT BANK VOLUNTEER FIRE COMPANY AND RESCUE SQUAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE WHEELER (PROVIDER RELATIONS SPECIALIST)
(304) 521-1576
Entity
Organization
Contact information
Practice address
15998 PAINT BANK ROAD, PAINT BANK, VA 24131
(540) 897-5200
Mailing address
836 4TH AVENUE, HUNTINGTON, WV 25701-1407
(304) 521-1576
(304) 521-1768
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
510
VA
3416L0300X
Land Ambulance
510
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508022690
—
VA
05
—
3810014404
—
WV
Enumeration date
07/29/2008
Last updated
10/18/2012
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