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General NPI Number Information
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NPI Number | 1497705255
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Entity Type | Organization
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Legal Business Name | KENBRIDGE EMERGENCY SQUAD, INC.
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 915 EAST 5TH AVE
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City | KENBRIDGE
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State | VA
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Zip | 23944
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Country | US
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Telephone | 434-676-4848
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Fax | 434-676-4848
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Provider Business Mailing Address
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Address Line | PO BOX 328
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City | KENBRIDGE
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State | VA
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Zip | 23944
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Country | US
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Telephone | 434-676-4848
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Fax | 434-676-4824
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Authorized Official
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Title or Position | SECRETARY
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Name | KATHERINE EDMONDS STOKES
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Credential |
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Telephone | 434-676-4848
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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 | 176
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License Number State | VA
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