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General NPI Number Information
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NPI Number | 1235471830
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Entity Type | Organization
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Legal Business Name | MT ROGERSVOLUNTEER FIRE DEPARTMENT
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Dates
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Enumeration Date | 03/21/2013
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Last Update Date | 03/21/2013
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Provider Practice Location Address
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Address Line | 51 FIRE HOUSE RD
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City | WHITETOP
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State | VA
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Zip | 24292
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Country | US
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Telephone | 276-388-3422
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Fax | 276-388-2854
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Provider Business Mailing Address
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Address Line | PO BOX 47
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City | WHITETOP
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State | VA
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Zip | 24292-0047
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Country | US
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Telephone | 276-388-3422
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Fax | 276-388-2854
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Authorized Official
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Title or Position | CHIEF
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Name | RICHARD BLEVINS
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Credential |
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Telephone | 276-388-3422
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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 | 387
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License Number State | VA
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