Provider Demographics
NPI:1972537082
Name:TUNNELTON COMMUNITY AMBULANCE SERVICE
Entity Type:Organization
Organization Name:TUNNELTON COMMUNITY AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-473-8988
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-0129
Mailing Address - Country:US
Mailing Address - Phone:304-473-8988
Mailing Address - Fax:304-472-9849
Practice Address - Street 1:STATE ROUTE 26
Practice Address - Street 2:
Practice Address - City:TUNNELTON
Practice Address - State:WV
Practice Address - Zip Code:26444
Practice Address - Country:US
Practice Address - Phone:304-473-8988
Practice Address - Fax:304-472-9849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV0214673416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0145772000Medicaid
WV9368281Medicare PIN
WV590007270Medicare PIN
WV9117801Medicare PIN