Provider Demographics
NPI:1073512414
Name:MJS ENTERPRISES INC
Entity Type:Organization
Organization Name:MJS ENTERPRISES INC
Other - Org Name:ST JOSEPHS AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DWANE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEEKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-424-4670
Mailing Address - Street 1:836 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-1407
Mailing Address - Country:US
Mailing Address - Phone:800-676-4785
Mailing Address - Fax:304-522-4222
Practice Address - Street 1:1619 SAINT MARYS AVE
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3346
Practice Address - Country:US
Practice Address - Phone:304-424-4670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY55001333Medicaid
WV080051800OtherBLACK LUNG
WVP00046067OtherRAILROAD MEDICARE
WV001705619OtherBLUE CROSS BLUE SHIELD
OH2439721Medicaid
WV8003072000Medicaid
WV612941100OtherFEDERAL DEPT OF LABOR
WV=========OtherUMWA
OH=========00OtherOH WORKERS COMP
KY55001333Medicaid
WV8003072000Medicaid
WVP00046067OtherRAILROAD MEDICARE