Healthcare Provider Details

I. General information

NPI: 1740428960
Provider Name (Legal Business Name): SHENANDOAH RESCUE SQUAD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2009
Last Update Date: 04/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

544 4TH ST
SHENANDOAH VA
22849-1613
US

IV. Provider business mailing address

544 4TH ST
SHENANDOAH VA
22849-1613
US

V. Phone/Fax

Practice location:
  • Phone: 877-731-5464
  • Fax: 800-234-1627
Mailing address:
  • Phone: 877-731-5464
  • Fax: 800-234-1627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberEMS AGENCY # 249
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberEMS AGENCY # 249
License Number StateVA

VIII. Authorized Official

Name: MR. DAVID HUFFMAN
Title or Position: CAPTAIN
Credential:
Phone: 877-731-5464