Organization Active NPI

Gilmer County Ambulance Service

  • Ambulance
  • Glenville, WV
National Provider Identifier
1679560361
Registry record updated Sep 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
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, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2020

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0145299000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070613000644 WV Part B Supplier - Ambulance Service Supplier 5799883880 Practice locations: Glenville, WV

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D0992906Gilmer County Ambulance Service230 West Main Street, Glenville, WV 26351Certificate of waiverOct 29, 2027

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.