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General NPI Number Information
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NPI Number | 1356686299
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Entity Type | Organization
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Legal Business Name | BLACKSTONE VOL.FIRE DEPT
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Dates
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Enumeration Date | 12/04/2012
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Last Update Date | 12/04/2012
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Provider Practice Location Address
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Address Line | 318 CHURCH ST
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City | BLACKSTONE
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State | VA
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Zip | 23824-1602
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Country | US
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Telephone | 434-292-3933
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Fax | 434-292-1184
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Provider Business Mailing Address
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Address Line | 318 CHURCH ST
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City | BLACKSTONE
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State | VA
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Zip | 23824-1602
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Country | US
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Telephone | 434-292-3933
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Fax | 434-292-1184
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Authorized Official
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Title or Position | 2ND LT.
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Name | MR. BENJAMIN ADAM HAUG
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Credential | EMT
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Telephone | 14342945855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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