| NPI | 1205169133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE WHEELER Provider Relations Specialist 800-676-4785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3416L0300X Ambulance, Land Transport (Licence: WV WVEMS) |
| Additional Taxonomies | 3416L0300X Ambulance, Land Transport |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2010-03-11 |