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General NPI Number Information
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NPI Number | 1760740435
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Entity Type | Organization
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Legal Business Name | DAN RIVER EMERGENCY SERVICES LLC
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Dates
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Enumeration Date | 05/01/2012
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Last Update Date | 01/22/2015
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Provider Practice Location Address
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Address Line | 142 S MAIN ST
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City | DANVILLE
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State | VA
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Zip | 24541-2922
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Country | US
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Telephone | 469-401-2386
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Fax | 919-425-0478
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Provider Business Mailing Address
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Address Line | 3114 CROASDAILE DR SUITE 200
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City | DURHAM
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State | NC
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Zip | 27705-2508
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Country | US
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Telephone | 469-401-2386
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Fax | 919-425-0478
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | TENNA BEHM
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Credential |
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Telephone | 469-401-2386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State | VA
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