1407983547 NPI number — BELINGTON EMERGENCY SQUAD INC

Table of content: (NPI 1407983547)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407983547 NPI number — BELINGTON EMERGENCY SQUAD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BELINGTON EMERGENCY SQUAD INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407983547
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 922
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26250-0922
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-823-2010
Provider Business Mailing Address Fax Number:
304-823-2792

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44 ELLIOT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26250-2625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-823-2010
Provider Business Practice Location Address Fax Number:
304-823-2692
Provider Enumeration Date:
02/27/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HART
Authorized Official First Name:
DEREK
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
304-823-2010

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 341600000X , with the licence number: WVEMS , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000226703 . This is a "BLUE CROSS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 0144848000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 088558800 . This is a "BLACK LUNG" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 590029193 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




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