Stafford EMS

Organization Active NPI Land Ambulance · Gilbert, WV

NPI 1063501153 · NPPES record last updated Sep 22, 2008

Key facts

NPI
1063501153
Entity type
Organization (NPI type 2)
Primary specialty
Land Ambulance 3416L0300X
License
045225 (WV)
Legal business name
STAFFORD EMS
Practice address
4071 Venus St
Gilbert, WV 25621-1098
Phone
(304) 664-2330
NPI assigned
Oct 12, 2006
Organization subpart
No

Authorized official

Name
Kendell A Simpson
Title
Owner
Phone
(304) 664-2330

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 045225 WV Yes

Addresses

Primary practice location

4071 Venus St
Gilbert, WV 25621-1098

Mailing address

PO Box 1098
Gilbert, WV 25621-1098
Phone (304) 664-2330

Other identifiers

IdentifierTypeStateIssuer
0144793000MedicaidWV

Other providers in Gilbert, WV

All providers in Gilbert, WV · Land Ambulance in West Virginia

Sources for this page

Verify at the official NPI Registry.