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General NPI Number Information
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NPI Number | 1104814508
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Entity Type | Organization
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Legal Business Name | THE ROANOKE VALLEY RESCUE SQUAD, INC
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 201 WASHINGTON ST
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City | ROANOKE RAPIDS
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State | NC
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Zip | 27870-2026
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Country | US
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Telephone | 252-537-7181
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Fax | 252-537-6445
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Provider Business Mailing Address
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Address Line | PO BOX 863
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City | LEWISVILLE
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State | NC
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Zip | 27023-0863
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Country | US
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Telephone | 800-948-7991
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Fax | 336-766-1279
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Authorized Official
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Title or Position | EMS DIRECTOR
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Name | MR. MARK COLLIER
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Credential |
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Telephone | 252-537-7181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 1380
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License Number State | NC
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