Healthcare Provider Details

I. General information

NPI: 1649509365
Provider Name (Legal Business Name): RURAL RETREAT VOLUNTEER EMERGENCY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 EAST RAILROAD AVENUE
RURAL RETREAT VA
24368-0000
US

IV. Provider business mailing address

PO BOX 111
RURAL RETREAT VA
24368-0111
US

V. Phone/Fax

Practice location:
  • Phone: 276-686-6964
  • Fax:
Mailing address:
  • Phone: 276-686-6964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number210
License Number StateVA

VIII. Authorized Official

Name: SALLY EARLES
Title or Position: CAPTAIN
Credential:
Phone: 276-686-6964