Provider Demographics
NPI: | 1902179500 |
---|---|
Name: | HEALTHNET INC |
Entity Type: | Organization |
Organization Name: | HEALTHNET INC |
Other - Org Name: | HEALTHNET AEROMEDICAL SERVICES |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT/CEO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | CLINTON |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | BURLEY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 304-340-8000 |
Mailing Address - Street 1: | 110 WYOMING ST |
Mailing Address - Street 2: | |
Mailing Address - City: | CHARLESTON |
Mailing Address - State: | WV |
Mailing Address - Zip Code: | 25302-2340 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 304-340-8000 |
Mailing Address - Fax: | 304-340-8007 |
Practice Address - Street 1: | 110 WYOMING ST |
Practice Address - Street 2: | |
Practice Address - City: | CHARLESTON |
Practice Address - State: | WV |
Practice Address - Zip Code: | 25302-2340 |
Practice Address - Country: | US |
Practice Address - Phone: | 304-340-8000 |
Practice Address - Fax: | 304-340-8007 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-02-14 |
Last Update Date: | 2013-02-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WV | 32065 | 3416L0300X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 3416L0300X | Transportation Services | Ambulance | Land Transport |