Organization
WEIRTON AREA AMBULANCE & RESCUE SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PENNY ANN BRICKER (MEDICARE MANAGER)
(304) 797-1233
Entity
Organization
Contact information
Practice address
1305 PENNSYLVANIA AVENUE, WEIRTON, WV 26062
(304) 797-1233
(304) 748-5445
Mailing address
1305 PENNSYLVANIA AVENUE, WEIRTON, WV 26062
(304) 797-1233
(304) 748-5445
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000213152
MOUNTAIN STATE BLUE CROSS
WV
05
—
014558700
—
WV
01
—
0300810
OHIO DOW
OH
Enumeration date
07/10/2006
Last updated
02/02/2012
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