Provider Demographics
NPI:1922038215
Name:MORGAN COUNTY RESCUE SERVICE INC
Entity Type:Organization
Organization Name:MORGAN COUNTY RESCUE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL/PERSONNEL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RENEA
Authorized Official - Middle Name:M
Authorized Official - Last Name:STANSBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-258-4594
Mailing Address - Street 1:1258 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:25411-4800
Mailing Address - Country:US
Mailing Address - Phone:304-258-4594
Mailing Address - Fax:304-258-6218
Practice Address - Street 1:1258 VALLEY RD
Practice Address - Street 2:
Practice Address - City:BERKELEY SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:25411-4800
Practice Address - Country:US
Practice Address - Phone:304-258-4594
Practice Address - Fax:304-258-6218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV0496203416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD777568700Medicaid
WV0145392000Medicaid
WV407590064Medicare ID - Type UnspecifiedRRMCR
MD777568700Medicaid