Active NPI
Gilmer County Ambulance Service
- Ambulance
- Glenville, WV
National Provider Identifier
1679560361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- Legal business name
- GILMER COUNTY AMBULANCE SERVICE
- Practice address
- 230 W Main St
Glenville, WV 26351-1051 - Phone
- (304) 462-5695
- Fax
- (304) 462-4266
- NPI assigned
- Sep 29, 2005
- Last updated
- Sep 18, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Thomas E Sirbaugh
- Title
- Manager/Paramedic
- Phone
- (304) 462-5695
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | NU | Primary |
Addresses
Primary practice location
230 W Main St
Glenville, WV 26351-1051
Mailing address
PO Box 129
Buckhannon, WV 26201-0129
Phone (304) 473-8988
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0145299000 | Medicaid | WV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WV
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070613000644 | WV | Part B Supplier - Ambulance Service Supplier | 5799883880 | Practice locations: Glenville, WV |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 51D0992906 | Gilmer County Ambulance Service | Certificate of waiver | Oct 29, 2027 |
National Provider Directory
National Provider DirectoryLocations
230 W Main St
Glenville, WV 26351
Phone (304) 462-5695
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1600387200000",
"number": "1679560361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 129",
"city": "BUCKHANNON",
"state": "WV",
"postal_code": "262010129",
"telephone_number": "304-473-8988",
"fax_number": "304-206-3141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 W MAIN ST",
"city": "GLENVILLE",
"state": "WV",
"postal_code": "263511051",
"telephone_number": "304-462-5695",
"fax_number": "304-462-4266"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GILMER COUNTY AMBULANCE SERVICE",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-29",
"last_updated": "2020-09-18",
"certification_date": "2020-09-18",
"status": "A",
"authorized_official_last_name": "SIRBAUGH",
"authorized_official_first_name": "THOMAS",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "MANAGER/PARAMEDIC",
"authorized_official_telephone_number": "304-462-5695"
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0145299000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Glenville, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.