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NPI 1629033667

NPI 1629033667 : WASHINGTON COUNTY FIRE RESCUE 1 INC. : BRISTOL, VA

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General NPI Number Information
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    NPI Number           |    1629033667
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    Entity Type          |    Organization 
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    Legal Business Name  |    WASHINGTON COUNTY FIRE RESCUE 1 INC. 
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Dates
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    Enumeration Date     |    04/20/2006
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    Last Update Date     |    06/16/2021
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Provider Practice Location Address
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    Address Line         |    15222 LEE HIGHWAY 
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    City                 |    BRISTOL
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    State                |    VA
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    Zip                  |    24202-4010
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    Country              |    US
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    Telephone            |    276-669-1411
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    Fax                  |    276-642-0200
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Provider Business Mailing Address
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    Address Line         |    PO BOX 9150 
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    City                 |    PADUCAH
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    State                |    KY
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    Zip                  |    42002-9150
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    Country              |    US
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    Telephone            |    270-744-9600
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    Fax                  |    270-744-8642
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Authorized Official
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    Title or Position    |    DIRECTOR
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    Name                 |     CHARLES  HAROSKY 
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    Credential           |    
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    Telephone            |    276-669-1411
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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       |    00699
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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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