Provider Demographics
NPI:1114038288
Name:KAMP CENTRAL AMBULANCE SERVICE, INC.
Entity type:Organization
Organization Name:KAMP CENTRAL AMBULANCE SERVICE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:NREMTP
Authorized Official - Phone:304-329-1614
Mailing Address - Street 1:PO BOX 911
Mailing Address - Street 2:
Mailing Address - City:MABSCOTT
Mailing Address - State:WV
Mailing Address - Zip Code:25871-0911
Mailing Address - Country:US
Mailing Address - Phone:304-253-1059
Mailing Address - Fax:304-253-1965
Practice Address - Street 1:133 WELLSLEY ST
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:WV
Practice Address - Zip Code:26537-1234
Practice Address - Country:US
Practice Address - Phone:304-329-1614
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVNO NUMBER ON LICENSE3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0145340000Medicaid
WV0145340000Medicaid