Healthcare Provider Details

I. General information

NPI: 1164561601
Provider Name (Legal Business Name): ALLEN'S AMBULANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 11/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4731 BELL RD
DILLWYN VA
23936
US

IV. Provider business mailing address

4731 BELL RD
DILLWYN VA
23936
US

V. Phone/Fax

Practice location:
  • Phone: 434-988-3170
  • Fax: 434-983-1945
Mailing address:
  • Phone: 434-988-3170
  • Fax: 434-983-1945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. SAMANTHA B BERSCH
Title or Position: SUPERVISOR
Credential: SUPERVISOR
Phone: 434-983-3170