Healthcare Provider Details

I. General information

NPI: 1811997745
Provider Name (Legal Business Name): GILES LIFESAVING & RESCUE SQUAD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 10/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 WENONAH AVE
PEARISBURG VA
24134-2285
US

IV. Provider business mailing address

836 4TH AVE
HUNTINGTON WV
25701-1407
US

V. Phone/Fax

Practice location:
  • Phone: 540-921-4376
  • Fax:
Mailing address:
  • Phone: 304-522-7533
  • Fax: 304-522-4222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number218
License Number StateVA

VIII. Authorized Official

Name: ROBERT CARTER
Title or Position: CHIEF
Credential:
Phone: 540-599-1301