Organization
TAYLOR COUNTY EMERGENCY SQUAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAVIN WATKINS (DIRECTOR)
(304) 265-0904
Entity
Organization
Contact information
Practice address
797 GEORGE WASHINGTON HWY., GRAFTON, WV 26354
(304) 265-0904
(304) 265-0906
Mailing address
PO BOX 161, GRAFTON, WV 26354
(304) 265-0904
(304) 265-0906
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
54633
WV
341600000X
Ambulance
—
WV
341600000X
Ambulance
—
—
3416L0300X
Land Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000207283
MOUNTAIN STATE BCBS
WV
05
—
0145530000
—
WV
01
—
0161950
UMWA HEALTH RETIREMENT FU
WV
Enumeration date
05/04/2007
Last updated
08/01/2023
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