{"npi":"1982603270","type":"NPI-2","status":"active","name":{"display":"Tyler County Emergency Squad Unit One Middlebourne INC","other":[],"organization_name":"TYLER COUNTY EMERGENCY SQUAD UNIT ONE MIDDLEBOURNE INC","authorised_official":"Clara Wells"},"specialty":{"primary_taxonomy":"3416L0300X","primary_taxonomy_description":"Land Ambulance","slug":"land-ambulance","schema_org_specialty":null,"all":[{"code":"3416L0300X","description":"Land Ambulance","primary":true,"state":"WV","license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"100 WILCOX AVENUE","city":"MIDDLEBOURNE","state":"WV","postal_code":"261499635","country_code":"US","phone":"3047584067","fax":"3044554275"},{"purpose":"MAILING","street_1":"836 4TH AVE","city":"HUNTINGTON","state":"WV","postal_code":"257011407","country_code":"US","phone":"8006764785","fax":"3045224222"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"0145554001","state":"WV","issuer":null},{"type_code":"01","label":"Other","value":"1407316","state":"WV","issuer":"UMWA"},{"type_code":"01","label":"Other","value":"251045","state":"WV","issuer":"CARELINK"},{"type_code":"01","label":"Other","value":"001704940","state":"WV","issuer":"BLUE CROSS"},{"type_code":"01","label":"Other","value":"080013800","state":"WV","issuer":"BLACK LUNG"},{"type_code":"01","label":"Other","value":"590029271","state":"WV","issuer":"RAILROAD MEDICARE"},{"type_code":"05","label":"Medicaid","value":"0273181","state":"OH","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20031210000264","type_code":"12-59","type_desc":"PART B SUPPLIER - AMBULANCE SERVICE SUPPLIER","state":"WV","pac_id":"1355247487"}]},"enumeration_date":"2005-07-19","last_updated":"2016-09-21","_meta":{"source":"NPPES","snapshot_date":"2016-09-21","doc_url":"https://findmynpi.com/api"}}