Provider Demographics
NPI:1588204028
Name:FIRST OUT EMS, LLC.
Entity Type:Organization
Organization Name:FIRST OUT EMS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VARNER
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:304-940-2029
Mailing Address - Street 1:PO BOX 243
Mailing Address - Street 2:
Mailing Address - City:DURBIN
Mailing Address - State:WV
Mailing Address - Zip Code:26264-0243
Mailing Address - Country:US
Mailing Address - Phone:304-456-4509
Mailing Address - Fax:304-456-4510
Practice Address - Street 1:313 INDUSTRIAL PARK RD
Practice Address - Street 2:SUITE 3
Practice Address - City:BELINGTON
Practice Address - State:WV
Practice Address - Zip Code:26250
Practice Address - Country:US
Practice Address - Phone:304-940-2029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-13
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1588204028Medicaid