Organization
MASON COUNTY EMERGENCY AMBULANCE SERVICE AUTHORITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHUCK BLAKE (CHIEF)
(304) 675-6134
Entity
Organization
Contact information
Practice address
911 EMERGENCY DRIVE, PT PLEASANT, WV 25550-2005
(304) 675-6134
(304) 675-7433
Mailing address
836 4TH AVE, HUNTINGTON, WV 25701-1407
(800) 676-4785
(304) 522-4222
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
WV EMS
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001705580
BLUE CROSS BLUE SHIELD
WV
01
—
080025800
BLACK LUNG
WV
05
—
2196556
—
OH
01
—
590013584
RAILROAD MEDICARE
WV
05
—
9000056000
—
WV
Enumeration date
07/13/2005
Last updated
10/17/2012
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