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General NPI Number Information
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NPI Number | 1740230705
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Entity Type | Organization
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Legal Business Name | HALIFAX COUNTY RESCUE SQUAD, INC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 04/23/2021
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Provider Practice Location Address
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Address Line | 700 HAMILTON BLVD
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City | SOUTH BOSTON
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State | VA
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Zip | 24592
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Country | US
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Telephone | 434-572-3960
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Fax | 434-572-3969
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Provider Business Mailing Address
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Address Line | PO BOX 183
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City | SOUTH BOSTON
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State | VA
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Zip | 24592
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Country | US
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Telephone | 434-572-3960
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Fax | 434-572-3969
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDREW J RICHARDSON JR.
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Credential |
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Telephone | 434-572-3960
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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 | 169
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License Number State | VA
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