Healthcare Provider Details

I. General information

NPI: 1821038530
Provider Name (Legal Business Name): PARKSLEY VOLUNTEER FIRE CO. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18431 DUNNE AVE
PARKSLEY VA
23421-0014
US

IV. Provider business mailing address

PO BOX 14
PARKSLEY VA
23421-0014
US

V. Phone/Fax

Practice location:
  • Phone: 757-665-6977
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number353
License Number StateVA

VIII. Authorized Official

Name: FRED MATTHEWS
Title or Position: PRESIDENT
Credential:
Phone: 757-665-6977