Organization
TERRA ALTA COMMUNITY AMBULANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARILYN JOYCE METHENY (VICE PRESIDENT)
(304) 789-6006
Entity
Organization
Contact information
Practice address
1124 E STATE AVE, TERRA ALTA, WV 26764-1465
(304) 789-6566
(304) 789-6566
Mailing address
PO BOX 129, BUCKHANNON, WV 26201-0129
(304) 473-8988
(304) 472-9849
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0145535000
—
WV
05
—
409853600
—
MD
Enumeration date
08/16/2005
Last updated
06/25/2009
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