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General NPI Number Information
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NPI Number | 1851671606
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Entity Type | Organization
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Legal Business Name | DANVILLE LIFE SAVING AND FIRST AID CREW INC
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Dates
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Enumeration Date | 08/25/2011
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Last Update Date | 12/08/2011
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Provider Practice Location Address
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Address Line | 202 CHRISTOPHER LN
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City | DANVILLE
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State | VA
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Zip | 24541-2661
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Country | US
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Telephone | 434-792-2739
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Fax | 434-793-3525
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Provider Business Mailing Address
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Address Line | 202 CHRISTOPHER LN
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City | DANVILLE
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State | VA
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Zip | 24541-2661
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Country | US
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Telephone | 434-792-2739
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Fax | 434-793-3525
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ROBERT T PRUETT JR.
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Credential |
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Telephone | 434-792-2739
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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 | 410
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License Number State | VA
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