Provider Demographics
NPI:1316942329
Name:RITCHIE COUNTY AMBULANCE AUTHORITY, INC
Entity type:Organization
Organization Name:RITCHIE COUNTY AMBULANCE AUTHORITY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/BILLING CLERK
Authorized Official - Prefix:
Authorized Official - First Name:SHERILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:STAHLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-659-2120
Mailing Address - Street 1:403 W MYLES AVENUE
Mailing Address - Street 2:
Mailing Address - City:PENNSBORO
Mailing Address - State:WV
Mailing Address - Zip Code:26415-1330
Mailing Address - Country:US
Mailing Address - Phone:304-659-2120
Mailing Address - Fax:304-659-1086
Practice Address - Street 1:1610 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:WV
Practice Address - Zip Code:26362-9201
Practice Address - Country:US
Practice Address - Phone:304-643-2369
Practice Address - Fax:304-643-5291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0145486000Medicaid
WV0145486000Medicaid