Healthcare Provider Details

I. General information

NPI: 1164648317
Provider Name (Legal Business Name): CAROLINE COUNTY BOARD OF SUPERVISORS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 08/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17202 RICHMOND TURNPIKE
BOWLING GREEN VA
22427
US

IV. Provider business mailing address

PO BOX 447
BOWLING GREEN VA
22427-0447
US

V. Phone/Fax

Practice location:
  • Phone: 804-633-9831
  • Fax: 804-633-9832
Mailing address:
  • Phone: 804-633-9831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: EDWARD FUZY
Title or Position: DIRECTOR
Credential:
Phone: 804-633-9831