Healthcare Provider Details

I. General information

NPI: 1356311476
Provider Name (Legal Business Name): FRIENDSHIP AMBULANCE SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 W MAIN ST
WISE VA
24293
US

IV. Provider business mailing address

PO BOX 2410
WISE VA
24293
US

V. Phone/Fax

Practice location:
  • Phone: 276-328-9111
  • Fax: 276-328-3117
Mailing address:
  • Phone: 276-328-9111
  • Fax: 276-328-3117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. RONALD K FREEMAN
Title or Position: PRESIDENT OWNER
Credential: PRESIDENT
Phone: 276-328-9111