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General NPI Number Information
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NPI Number | 1649634080
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Entity Type | Organization
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Legal Business Name | JASPER VOLUNTEER FIRE DEPARTMENT
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Dates
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Enumeration Date | 04/12/2016
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Last Update Date | 04/12/2016
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Provider Practice Location Address
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Address Line | 25700 US HIGHWAY 23 N
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City | DUFFIELD
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State | VA
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Zip | 24244-2539
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Country | US
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Telephone | 276-523-6632
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Fax |
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Provider Business Mailing Address
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Address Line | 25700 US HIGHWAY 23 N
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City | DUFFIELD
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State | VA
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Zip | 24244-2539
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Country | US
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Telephone | 276-523-6632
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Fax |
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Authorized Official
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Title or Position | CHIEF
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Name | EARL LEONARD BOWEN
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Credential |
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Telephone | 276-523-2910
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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 |
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License Number State |
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