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SANDY RIDGE RESCUE SQUAD NPI 1720409246


NPI Information

NPI: 1720409246
Provider Name: SANDY RIDGE RESCUE SQUAD

Former Legal Business Name: SANDY RIDGE VOLUNTEER RESCUE SQUAD

Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
109 CARICO RDG
COEBURN, VA
ZIP 24230
Phone: (276) 395-3847
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SANDY RIDGE RESCUE SQUAD is a land transport ambulance in Coeburn, VA. SANDY RIDGE RESCUE SQUAD NPI is 1720409246. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Sandy Ridge Volunteer Rescue Squad.

The provider's business location address is:

109 CARICO RDG
COEBURN, VA
ZIP 24230-418
Phone: (276) 395-3847
Fax: (276) 395-3847

The provider's authorized official is Matthew D Slemp .
The authorized official title is President/captain and has the following contact phone number (276) 395-3847.

The enumeration date for this NPI number is 12/31/2013 and was last updated on 3/29/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13416L0300XAmbulanceLand TransportYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11720409246MEDICAIDVIRGINIA
2618431700OTHERVIRGINIADEPARTMENT OF LABOR
3Q453830001MEDICARE PINVIRGINIA
4618431700OTHERVIRGINIAFEDERAL BLACK LUNG PROGRAM
5P01603815MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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