Provider Demographics
NPI:1912992157
Name:RYNEAL FIRE COMPANY #1
Entity Type:Organization
Organization Name:RYNEAL FIRE COMPANY #1
Other - Org Name:RYNEAL MEDICAL TRANSPORT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HELMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-263-2900
Mailing Address - Street 1:PO BOX 2501
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25402-2501
Mailing Address - Country:US
Mailing Address - Phone:304-263-2900
Mailing Address - Fax:304-263-6680
Practice Address - Street 1:120 COMMERCE CIR
Practice Address - Street 2:STE 200
Practice Address - City:KEARNEYSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25430-4973
Practice Address - Country:US
Practice Address - Phone:304-263-2900
Practice Address - Fax:304-263-6680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV341600000X
WVWV EMS SYSTEM3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVP00148785OtherPALMETTO GBA RR MEDICARE
WV000294339OtherMOUNTAIN STATE BLUE CROSS
WV0145775000Medicaid
WV000294339OtherMOUNTAIN STATE BLUE CROSS