Provider Demographics
NPI:1831277532
Name:TOWN OF ANMOORE
Entity type:Organization
Organization Name:TOWN OF ANMOORE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR/DEPARTMENT HEAD
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROHRBOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-622-5649
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:304-206-3141
Practice Address - Street 1:100 SOUTH ASH STREET
Practice Address - Street 2:
Practice Address - City:ANMOORE
Practice Address - State:WV
Practice Address - Zip Code:26323
Practice Address - Country:US
Practice Address - Phone:304-622-5649
Practice Address - Fax:304-622-0275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0145673000Medicaid
WV0145673000Medicaid
9171691Medicare ID - Type Unspecified