Organization
TYLER COUNTY EMERGENCY SQUAD UNIT ONE MIDDLEBOURNE INC
Active
Organization
TYLER COUNTY EMERGENCY SQUAD UNIT ONE MIDDLEBOURNE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARA WELLS (CHIEF)
(304) 758-4067
Entity
Organization
Contact information
Practice address
100 WILCOX AVENUE, MIDDLEBOURNE, WV 26149-9635
(304) 758-4067
(304) 455-4275
Mailing address
836 4TH AVE, HUNTINGTON, WV 25701-1407
(800) 676-4785
(304) 522-4222
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001704940
BLUE CROSS
WV
05
—
0145554001
—
WV
05
—
0273181
—
OH
01
—
080013800
BLACK LUNG
WV
01
—
1407316
UMWA
WV
01
—
251045
CARELINK
WV
01
—
590029271
RAILROAD MEDICARE
WV
Enumeration date
07/19/2005
Last updated
09/21/2016
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