Provider Demographics
NPI:1235820689
Name:BOARD OF SUPERVISORS OF AMELIA CO
Entity Type:Organization
Organization Name:BOARD OF SUPERVISORS OF AMELIA CO
Other - Org Name:AMELIA COUNTY FIRE & EMS
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATIVE SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:SHAFFER
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-357-1736
Mailing Address - Street 1:PO BOX A
Mailing Address - Street 2:
Mailing Address - City:AMELIA COURT HOUSE
Mailing Address - State:VA
Mailing Address - Zip Code:23002-0066
Mailing Address - Country:US
Mailing Address - Phone:804-561-3914
Mailing Address - Fax:
Practice Address - Street 1:8930 OTTERBURN ROAD
Practice Address - Street 2:
Practice Address - City:AMELIA COURT HOUSE
Practice Address - State:VA
Practice Address - Zip Code:23002
Practice Address - Country:US
Practice Address - Phone:804-561-3336
Practice Address - Fax:804-561-5897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport