Provider Demographics
NPI:1164669628
Name:BASSETT RESCUE SQUAD INCORPORATED
Entity Type:Organization
Organization Name:BASSETT RESCUE SQUAD INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-732-3652
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:BASSETT
Mailing Address - State:VA
Mailing Address - Zip Code:24055-0510
Mailing Address - Country:US
Mailing Address - Phone:276-629-3107
Mailing Address - Fax:
Practice Address - Street 1:1950 RIVERSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:BASSETT
Practice Address - State:VA
Practice Address - Zip Code:24055
Practice Address - Country:US
Practice Address - Phone:276-629-3107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1553416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport