Healthcare Provider Details

I. General information

NPI: 1710090014
Provider Name (Legal Business Name): BOTETOURT COUNTY BOARD OF SUPERVISORS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 05/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N ROANOKE ST SUITE 1
FINCASTLE VA
24090-3018
US

IV. Provider business mailing address

4750 HEMPSTEAD STATION DR
KETTERING OH
45429-5164
US

V. Phone/Fax

Practice location:
  • Phone: 540-473-8401
  • Fax:
Mailing address:
  • Phone: 800-875-0136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number1128
License Number StateVA

VIII. Authorized Official

Name: DAVID FIRESTONE
Title or Position: EMERGENCY SERVICES SPECIALIST
Credential:
Phone: 540-473-8401