1912992157 NPI number — RYNEAL FIRE COMPANY #1

Table of content: (NPI 1912992157)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912992157 NPI number — RYNEAL FIRE COMPANY #1

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RYNEAL FIRE COMPANY #1
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:
RYNEAL MEDICAL TRANSPORT
Provider Other Organization Name Type Code:
3
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:
1912992157
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/04/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2501
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARTINSBURG
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25402-2501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-263-2900
Provider Business Mailing Address Fax Number:
304-263-6680

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 COMMERCE CIR
Provider Second Line Business Practice Location Address:
STE 200
Provider Business Practice Location Address City Name:
KEARNEYSVILLE
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25430-4973
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-263-2900
Provider Business Practice Location Address Fax Number:
304-263-6680
Provider Enumeration Date:
09/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HELMICK
Authorized Official First Name:
MARY
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
304-263-2900

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3416L0300X , with the licence number: WV EMS SYSTEM , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: P00148785 . This is a "PALMETTO GBA RR MEDICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 000294339 . This is a "MOUNTAIN STATE BLUE CROSS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 0145775000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".




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