Glen Dale Vol. Fire Dept, Inc.

Primary specialty

AmbulanceTaxonomy code 341600000X

License

WVEMS Issued in WV

Legal business name

GLEN DALE VOL. FIRE DEPT, INC.

Practice address

402 Wheeling Ave.
Glen Dale, WV 26038

Phone

(304) 845-8800

Fax

(304) 845-3475

NPI assigned

Jun 22, 2005

Organization subpart

No

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

Authorized official

Name

Norman Pastorius

Title

Chief

Phone

(304) 845-8800

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Locations

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1801892013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 4TH AVENUE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25701",
            "telephone_number": "304-522-7533",
            "fax_number": "304-522-4222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 WHEELING AVE.",
            "city": "GLEN DALE",
            "state": "WV",
            "postal_code": "26038",
            "telephone_number": "304-845-8800",
            "fax_number": "304-845-3475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN DALE VOL. FIRE DEPT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "PASTORIUS",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "304-845-8800"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "WV",
            "license": "WVEMS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590013702",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0144885000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynn Franke, FNP
• Lisa Ann Gast
• Cathy Gellner, M.S. CCC-A
• Alber Lewis Ghobrial, MD
• Glen Dale Medicine & Pediatrics, PLLC
• Jodi Gottardi
• Amber Rhyan Gower, PHARM D
• Peri Gray
• Crystal Hall
• Sarah Cecelia Harmon, PA-C

• All providers in Glen Dale, WV
• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.