1801808456 NPI number — CABELL COUNTY EMERGENCY MEDICAL SERVICE

Table of content: (NPI 1801808456)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801808456 NPI number — CABELL COUNTY EMERGENCY MEDICAL SERVICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CABELL COUNTY EMERGENCY MEDICAL SERVICE
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:
1801808456
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
846 8TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25701-2804
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-526-9797
Provider Business Mailing Address Fax Number:
304-526-8553

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
846 8TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25701-2804
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-526-9797
Provider Business Practice Location Address Fax Number:
304-526-8553
Provider Enumeration Date:
08/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MERRY
Authorized Official First Name:
A. GORDON
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
304-526-9797

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  20602 , 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: 000212987 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 55690150 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1257996 . This is a "UNITED MINE WORKERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 269908 . This is a "FEDERAL BLACK LUNG" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 0450588 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0145233000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1026154 . This is a "WORKERS COMP ID#" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com