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General NPI Number Information
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NPI Number | 1225321805
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Entity Type | Organization
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Legal Business Name | LOWER KING AND QUEEN COUNTY VOLUNTEER FIRE DEPARTMENT INC
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Dates
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Enumeration Date | 05/16/2011
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Last Update Date | 05/16/2011
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Provider Practice Location Address
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Address Line | 250 BOHANNON PARK
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City | SHACKLEFORDS
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State | VA
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Zip | 23156
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Country | US
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Telephone | 804-366-2657
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Fax | 804-785-9411
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Provider Business Mailing Address
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Address Line | PO BOX 119
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City | MATTAPONI
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State | VA
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Zip | 23110-0119
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Country | US
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Telephone | 804-366-2657
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Fax |
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Authorized Official
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Title or Position | EMS CHIEF
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Name | ROBERT COGGSDALE
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Credential |
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Telephone | 804-366-2657
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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 | 1299
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License Number State | VA
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