Healthcare Provider Details

I. General information

NPI: 1235510306
Provider Name (Legal Business Name): TOWN OF TAZEWELL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2015
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N CENTRAL AVE
TAZEWELL VA
24651-1005
US

IV. Provider business mailing address

PO BOX 608
TAZEWELL VA
24651-0608
US

V. Phone/Fax

Practice location:
  • Phone: 276-988-9062
  • Fax: 276-988-9061
Mailing address:
  • Phone: 276-988-2501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1342
License Number StateVA

VIII. Authorized Official

Name: AARON D BUCHANAN SR.
Title or Position: MAYOR
Credential:
Phone: 276-988-2501