Provider Demographics
NPI:1235459462
Name:KING WILLIAM VOLUNTEER FIRE AND RESCUE
Entity Type:Organization
Organization Name:KING WILLIAM VOLUNTEER FIRE AND RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:IT PERSON
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:KOSEK
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:804-690-9659
Mailing Address - Street 1:PO BOX 139
Mailing Address - Street 2:
Mailing Address - City:AYLETT
Mailing Address - State:VA
Mailing Address - Zip Code:23009-0139
Mailing Address - Country:US
Mailing Address - Phone:804-769-4311
Mailing Address - Fax:
Practice Address - Street 1:7936 RICHMOND TAPPAHANNOCK HWY
Practice Address - Street 2:
Practice Address - City:AYLETT
Practice Address - State:VA
Practice Address - Zip Code:23009
Practice Address - Country:US
Practice Address - Phone:804-769-4311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-10
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA002923416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport