Provider Demographics
NPI:1639340615
Name:BUCKINGHAM COUNTY VOLUNTEER RESCUE SQUAD, INC.
Entity Type:Organization
Organization Name:BUCKINGHAM COUNTY VOLUNTEER RESCUE SQUAD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:SAFFORD
Authorized Official - Middle Name:EMORY
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-392-7923
Mailing Address - Street 1:PO BOX 444
Mailing Address - Street 2:
Mailing Address - City:DILLWYN
Mailing Address - State:VA
Mailing Address - Zip Code:23936-0444
Mailing Address - Country:US
Mailing Address - Phone:434-983-3560
Mailing Address - Fax:434-983-3566
Practice Address - Street 1:222 WINGO ROAD
Practice Address - Street 2:
Practice Address - City:DILLWYN
Practice Address - State:VA
Practice Address - Zip Code:23936
Practice Address - Country:US
Practice Address - Phone:434-983-3560
Practice Address - Fax:434-983-3566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2010-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1639340615Medicaid
VA1639340615Medicaid