Provider Demographics
NPI:1952301764
Name:ELK DISTRICT AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:ELK DISTRICT AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:D
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-446-5519
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:MAPLE STREET
Practice Address - Street 2:
Practice Address - City:ELK GARDEN
Practice Address - State:WV
Practice Address - Zip Code:26717
Practice Address - Country:US
Practice Address - Phone:304-446-5519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV080021600OtherBLACK LUNG
WV0145035000Medicaid
MD451200600Medicaid
WV1492687OtherUMWA
WV001705364OtherBLUE CROSS
WV590013940OtherRAILROAD MEDICARE
WV590013940OtherRAILROAD MEDICARE
MD451200600Medicaid
MD451200600Medicaid