Provider Demographics
NPI:1114110715
Name:VALLEY RESCUE SQUAD INC
Entity Type:Organization
Organization Name:VALLEY RESCUE SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:O'QUINN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-698-6242
Mailing Address - Street 1:PO BOX 9150
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-9150
Mailing Address - Country:US
Mailing Address - Phone:270-744-9600
Mailing Address - Fax:270-744-8642
Practice Address - Street 1:7720 HAYTERS GAP RD
Practice Address - Street 2:
Practice Address - City:SALTVILLE
Practice Address - State:VA
Practice Address - Zip Code:24370-4014
Practice Address - Country:US
Practice Address - Phone:276-944-5875
Practice Address - Fax:276-944-5875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA285341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA710466800OtherDOL
VA114110715Medicaid
VAP00475703OtherRAILROAD MEDICARE