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General NPI Number Information
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NPI Number | 1427025238
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Entity Type | Organization
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Legal Business Name | IVA RESCUE SQUAD
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9715 HIGHWAY 81 S
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City | IVA
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State | SC
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Zip | 29655
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Country | US
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Telephone | 864-348-6195
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Fax | 864-348-7117
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Provider Business Mailing Address
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Address Line | PO BOX 519
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City | IVA
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State | SC
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Zip | 29655
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Country | US
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Telephone | 864-348-6195
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Fax | 864-348-7117
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Authorized Official
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Title or Position | CHAIRMAN OF THE BOARD OF DIRECTORS
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Name | MRS. LINDA J BURDETTE
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Credential |
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Telephone | 864-348-6195
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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 | 007
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License Number State | SC
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