Healthcare Provider Details

I. General information

NPI: 1902867906
Provider Name (Legal Business Name): RESCUE 33 AMBULANCE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 03/05/2024
Certification Date: 03/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

RESCUE 33 AMBULANCE 1058 ALMARINE DRIVE
GRUNDY VA
24614
US

IV. Provider business mailing address

PO BOX 911
MABSCOTT WV
25871-0911
US

V. Phone/Fax

Practice location:
  • Phone: 276-935-4911
  • Fax:
Mailing address:
  • Phone: 304-575-2866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1142
License Number StateVA

VIII. Authorized Official

Name: MR. RANDY SUBER
Title or Position: OWNER
Credential:
Phone: 276-935-4911