Provider Demographics
NPI:1366496598
Name:GREATER MANASSAS VOL RESCUE SQUAD
Entity Type:Organization
Organization Name:GREATER MANASSAS VOL RESCUE SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ENRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-806-3329
Mailing Address - Street 1:PO BOX 123
Mailing Address - Street 2:ATTN TREASURER
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20108
Mailing Address - Country:US
Mailing Address - Phone:703-806-3329
Mailing Address - Fax:
Practice Address - Street 1:9322 CENTER STREET
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20108
Practice Address - Country:US
Practice Address - Phone:703-806-3329
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA93341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance