Organization
WIDENERS AMBULANCE SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE WIDENER (DIRECTOR)
(304) 862-4339
Entity
Organization
Contact information
Practice address
102 MAIN STREET, NORTHFORK, WV 24868
(304) 862-4339
Mailing address
PO BOX 728, NORTHFORK, WV 24868-0728
(304) 862-4339
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
NO NUMBER
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0144749000
—
WV
Enumeration date
01/25/2007
Last updated
09/02/2011
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