Provider Demographics
NPI:1689624660
Name:RICHMOND COUNTY RESCUE SQUAD
Entity Type:Organization
Organization Name:RICHMOND COUNTY RESCUE SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY DIRECTOR OF TRANS.
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CONLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-333-5089
Mailing Address - Street 1:PO BOX 1785
Mailing Address - Street 2:
Mailing Address - City:TAPPAHANNOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22560
Mailing Address - Country:US
Mailing Address - Phone:804-443-1968
Mailing Address - Fax:
Practice Address - Street 1:6674 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:VA
Practice Address - Zip Code:22572
Practice Address - Country:US
Practice Address - Phone:804-333-5089
Practice Address - Fax:804-333-5099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA282341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA38294OtherOPTIMA
VA330341OtherBC BS
VA330341OtherBC BS