Provider Demographics
NPI:1871593558
Name:GREENBRIER COUNTY EMERGENCY AMBULANCE SERVICE, INC
Entity type:Organization
Organization Name:GREENBRIER COUNTY EMERGENCY AMBULANCE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-645-2252
Mailing Address - Street 1:257 THIRD STREET
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-9461
Mailing Address - Country:US
Mailing Address - Phone:304-645-2252
Mailing Address - Fax:304-646-3215
Practice Address - Street 1:257 THIRD STREET
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-9461
Practice Address - Country:US
Practice Address - Phone:304-645-2252
Practice Address - Fax:304-646-3215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
WV31311341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV000222296OtherBLUE CROSS BLUE SHIELD
WV0145314000Medicaid
WV406590177OtherRAILROAD MEDICARE
WV086255900OtherBLACK LUNG
OH2644919Medicaid
VA010213584Medicaid
WV222078OtherCARELINK
WV222078OtherCARELINK
WV086255900OtherBLACK LUNG
WV406590177OtherRAILROAD MEDICARE
WV222078OtherCARELINK