Provider Demographics
NPI:1316192933
Name:CHATHAM RESCUE SQUAD INC
Entity Type:Organization
Organization Name:CHATHAM RESCUE SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:NOAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBBINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-250-0963
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:270-744-8413
Mailing Address - Fax:270-744-8642
Practice Address - Street 1:28 MILITARY DR
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:VA
Practice Address - Zip Code:24531-4632
Practice Address - Country:US
Practice Address - Phone:434-432-8827
Practice Address - Fax:434-432-3398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-24
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA709724700OtherDOL
VA1316192933Medicaid