Provider Demographics
NPI:1407054869
Name:NEW KENT COUNTY BOARD OF SUPERVISORS
Entity Type:Organization
Organization Name:NEW KENT COUNTY BOARD OF SUPERVISORS
Other - Org Name:NEW KENT FIRE-RESCUE
Other - Org Type:Other Name
Authorized Official - Title/Position:ACTING COUNTY ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:HATHAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-966-9629
Mailing Address - Street 1:P O BOX 210
Mailing Address - Street 2:
Mailing Address - City:NEW KENT
Mailing Address - State:VA
Mailing Address - Zip Code:23124-0210
Mailing Address - Country:US
Mailing Address - Phone:804-966-8574
Mailing Address - Fax:804-966-2903
Practice Address - Street 1:12025 COURTHOUSE CIRCLE
Practice Address - Street 2:SUITE 400
Practice Address - City:NEW KENT
Practice Address - State:VA
Practice Address - Zip Code:23124
Practice Address - Country:US
Practice Address - Phone:804-966-8574
Practice Address - Fax:804-966-2903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA693341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA190001981Medicare UPIN