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General NPI Number Information
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NPI Number | 1932271301
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Entity Type | Organization
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Legal Business Name | HIGHLANDS AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 02/18/2020
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Provider Practice Location Address
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Address Line | 265 W.MAIN STREET
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City | LEBANON
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State | VA
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Zip | 24266-3900
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Country | US
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Telephone | 276-889-5877
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Fax | 276-889-5799
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Provider Business Mailing Address
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Address Line | PO BOX 1017
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City | LEBANON
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State | VA
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Zip | 24266
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Country | US
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Telephone | 276-889-0600
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Fax | 276-889-4666
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MR. JASON ALLEN SUTHERLAND
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Credential |
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Telephone | 276-889-5877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 948
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License Number State | VA
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