Provider Demographics
NPI:1225184096
Name:CALHOUN COUNTY EMS INC
Entity Type:Organization
Organization Name:CALHOUN COUNTY EMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:304-354-7006
Mailing Address - Street 1:PO BOX 177
Mailing Address - Street 2:
Mailing Address - City:GRANTSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26147-0177
Mailing Address - Country:US
Mailing Address - Phone:304-354-7006
Mailing Address - Fax:304-354-7905
Practice Address - Street 1:4450 SOUTH CALHOUN HIGHWAY
Practice Address - Street 2:
Practice Address - City:GRANTSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26147-4450
Practice Address - Country:US
Practice Address - Phone:304-354-7006
Practice Address - Fax:304-354-7905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV042709341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
701004OtherMAMSI UNITED HEALTHCARE
000000000843OtherANTHEM BLUE CROSS BLUE SH
WV0144625000Medicaid
N1674954OtherTHE HEALTH PLAN
N1674954OtherTHE HEALTH PLAN