Healthcare Provider Details

I. General information

NPI: 1255337697
Provider Name (Legal Business Name): ROANOKE COUNTY BOARD OF SUPERVISORS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 04/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROANOKE COUNTY PUBLIC SAFETY CENTER 5925 COVE ROAD
ROANOKE VA
24019
US

IV. Provider business mailing address

PO BOX 20862
ROANOKE VA
24018-0087
US

V. Phone/Fax

Practice location:
  • Phone: 540-777-8701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number442
License Number StateVA

VIII. Authorized Official

Name: MR. STEPHEN GEORGE SIMON
Title or Position: DIVISION CHIEF
Credential:
Phone: 540-777-8701