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General NPI Number Information
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NPI Number | 1336330539
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Entity Type | Organization
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Legal Business Name | KING GEORGE COUNTY
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 02/03/2021
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Provider Practice Location Address
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Address Line | 10459 COURTHOUSE DR STE 200
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City | KING GEORGE
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State | VA
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Zip | 22485-3865
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Country | US
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Telephone | 540-775-9181
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Fax |
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Provider Business Mailing Address
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Address Line | 8122 KINGS HWY
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City | KING GEORGE
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State | VA
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Zip | 22485-7051
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Country | US
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Telephone | 540-775-9181
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Fax | 540-775-9060
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Authorized Official
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Title or Position | CHIEF
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Name | DAVID WAYNE MOODY
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Credential |
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Telephone | 540-775-8910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 1013
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State |
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