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General NPI Number Information
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NPI Number | 1922031061
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Entity Type | Organization
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Legal Business Name | BLUEFIELD RESCUE SQUAD INC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 11/13/2012
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Provider Practice Location Address
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Address Line | 1900 STADIUM DR
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City | BLUEFIELD
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State | WV
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Zip | 24701-3324
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Country | US
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Telephone | 304-325-8367
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Fax | 304-325-7149
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Provider Business Mailing Address
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Address Line | 1900 STADIUM DRIVE
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City | BLUEFIELD
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State | WV
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Zip | 24701-0311
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Country | US
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Telephone | 304-325-8367
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Fax | 304-325-7149
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. SAMUEL PENNINGTON
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Credential |
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Telephone | 304-325-9471
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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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