Basic Information
| Provider Information | |||||||||
| NPI: | 1881692796 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CASS VOLUNTEER FIRE AND RESCUE COMPANY, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 836 4TH AVE. | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 257010000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8006764785 | ||||||||
| FaxNumber: | 3045224222 | ||||||||
| Practice Location | |||||||||
| Address1: | HC RT 66 | ||||||||
| Address2: | |||||||||
| City: | CASS | ||||||||
| State: | WV | ||||||||
| PostalCode: | 249270000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044564118 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2005 | ||||||||
| LastUpdateDate: | 10/19/2012 | ||||||||
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| AuthorizedOfficialLastName: | REBINSKI | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF | ||||||||
| AuthorizedOfficialTelephone: | 3044564118 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 341600000X | NO NUMBER ASSIGNED | WV | Y | Transportation Services | Ambulance |
ID Information
| ID | Type | State | Issuer | Description | 221875 | 01 | WV | CARELINK | OTHER | 590014453 | 01 | WV | RAILROAD MEDICARE | OTHER | 000226683 | 01 | WV | BLUE CROSS | OTHER | 0144619000 | 05 | WV | MEDICAID |