Provider Demographics
NPI:1053190165
Name:TYLER COUNTY EMS
Entity type:Organization
Organization Name:TYLER COUNTY EMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:LOGSAN
Authorized Official - Last Name:SAILOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-652-2830
Mailing Address - Street 1:242 OXFORD ST
Mailing Address - Street 2:
Mailing Address - City:SISTERSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26175-1029
Mailing Address - Country:US
Mailing Address - Phone:304-652-2830
Mailing Address - Fax:304-521-1576
Practice Address - Street 1:242 OXFORD ST
Practice Address - Street 2:
Practice Address - City:SISTERSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26175-1029
Practice Address - Country:US
Practice Address - Phone:304-652-2830
Practice Address - Fax:304-521-1576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport