Provider Demographics
NPI:1326046228
Name:CAMERON VOLUNTEER EMERGENCY SQUAD INC
Entity Type:Organization
Organization Name:CAMERON VOLUNTEER EMERGENCY SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-686-2707
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 1:69 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:WV
Practice Address - Zip Code:26033-1113
Practice Address - Country:US
Practice Address - Phone:304-686-2707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV225006OtherCARELINK
OH550771821OtherANTHEM
WV001705582OtherBLUE CROSS
OH55077182100OtherOH WORKERS COMP
OH2219987Medicaid
WV550771821OtherWV WORKERS COMPE
WV550771821001OtherTRICARE
WV590014171OtherRAILROAD MEDICARE
WV0145244000Medicaid
WV550771821OtherWV WORKERS COMPE