Healthcare Provider Details

I. General information

NPI: 1194992230
Provider Name (Legal Business Name): ST CHARLES VOLUNTEER RESCUE SQUAD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2008
Last Update Date: 02/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2461 SAINT CHARLES ROAD
SAINT CHARLES VA
24282-0208
US

IV. Provider business mailing address

PO BOX 218
SAINT CHARLES VA
24282-0218
US

V. Phone/Fax

Practice location:
  • Phone: 276-383-4227
  • Fax:
Mailing address:
  • Phone: 276-383-4017
  • Fax: 276-383-4447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number970
License Number StateVA

VIII. Authorized Official

Name: JEFFREY L OAKS
Title or Position: CAPTAIN
Credential:
Phone: 276-383-4017