Organization
BLUEFIELD RESCUE SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL PENNINGTON (ADMINISTRATOR)
(304) 325-9471
Entity
Organization
Contact information
Practice address
1900 STADIUM DR, BLUEFIELD, WV 24701-3324
(304) 325-8367
(304) 325-7149
Mailing address
1900 STADIUM DRIVE, BLUEFIELD, WV 24701-0311
(304) 325-8367
(304) 325-7149
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000207787
BLUE CROSS
WV
05
—
0145962000
—
WV
Enumeration date
07/09/2006
Last updated
11/13/2012
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