Princeton Rescue Squad Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

12810 Issued in WV

Legal business name

PRINCETON RESCUE SQUAD INC

Practice address

701 Stafford Dr
Princeton, WV 24740-2447

Phone

(304) 425-3914

Fax

(304) 431-3518

NPI assigned

Jun 2, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Stacey Hicks

Title

C.E.O./Administrator

Phone

(304) 425-3914

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1609814607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 STAFFORD DR",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402447",
            "telephone_number": "304-425-3914",
            "fax_number": "304-431-3518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 STAFFORD DR",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402447",
            "telephone_number": "304-425-3914",
            "fax_number": "304-431-3518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON RESCUE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "C.E.O./ADMINISTRATOR",
        "authorized_official_telephone_number": "304-425-3914",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WV",
            "license": "12810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0146003000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Princeton Health Care Center
• Princeton Internists Inc
• Princeton Pediatrics Lab
• Princeton Pediatrics, P.C.
• Princeton Psychological LLC
• Princeton Surgical Group Inc
• Princeton Urological Group Inc
• Priority One Home Care, LLC
• Jason L Pritchett, PHARMD
• Professional Imaging, Inc.

• Land Ambulance in Princeton, WV
• Providers in Princeton, WV by specialty
• Land Ambulance in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.