Provider Demographics
NPI:1598800666
Name:BIG STONE GAP RESCUE SQUAD, INC.
Entity Type:Organization
Organization Name:BIG STONE GAP RESCUE SQUAD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:STURGILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-523-0251
Mailing Address - Street 1:361 SHAWNEE AVE E
Mailing Address - Street 2:
Mailing Address - City:BIG STONE GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24219-2815
Mailing Address - Country:US
Mailing Address - Phone:276-523-0251
Mailing Address - Fax:
Practice Address - Street 1:361 SHAWNEE AVENUE
Practice Address - Street 2:
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219-0128
Practice Address - Country:US
Practice Address - Phone:276-523-0251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA3341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance