{
"Npi": {
"NPI": "1568638724",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PRATER VOLUNTEER RESCUE SQUAD INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 145",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VANSANT",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "24656-0145",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "276-597-7173",
"MailingAddressFaxNumber": "276-597-7377",
"FirstLinePracticeLocationAddress": "1028 KILLDEER LANE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GRUNDY",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "24614",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "276-597-7173",
"PracticeLocationAddressFaxNumber": "276-597-7377",
"EnumerationDate": "05/07/2008",
"LastUpdateDate": "05/29/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HARRIS",
"AuthorizedOfficialFirstName": "JAMES",
"AuthorizedOfficialMiddleName": "WESLEY",
"AuthorizedOfficialTitle": "ASST. CHIEF",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PARAMEDIC",
"AuthorizedOfficialTelephoneNumber": "276-202-7600",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3416L0300X",
"TaxonomyName": "Land Ambulance",
"LicenseNumber": "843",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}