MEDICARE: KING WILLIAM COUNTY BOARD OF SUPERVISORS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	1254	VA
2	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1003130188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KING WILLIAM COUNTY BOARD OF SUPERVISORS

Provider Business Mailing Address
First Line	:	180 HORSE LANDING ROAD #4
Second Line	:
City	:	KING WILLIAM
State	:	VA
Zip	:	23086-3222
Country	:	US
Telephone Number	:	804-769-4929
Fax Number	:	804-769-4964

Provider Business Practice Location Address
First Line	:	7936 RICHMOND TAPPAHANNOCK HIGHWAY
Second Line	:
City	:	AYLETT
State	:	VA
Zip	:	23086-2743
Country	:	US
Telephone Number	:	804-769-4961
Fax Number	:

Authorized Official
Title or Position	:	CHIEF
Name	:	RONALD BROWN
Credential	:
Telephone Number	:	804-769-4982

Provider Enumeration Date	:	03/18/2010
Last Update Date	:	10/28/2025

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Directions to “KING WILLIAM COUNTY BOARD OF SUPERVISORS ” Practice Location

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