Provider Demographics
NPI:1699812495
Name:BLUE RIDGE VOLUNTEER RESCUE SQUAD INC
Entity Type:Organization
Organization Name:BLUE RIDGE VOLUNTEER RESCUE SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESCUE SQUAD BILLING REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-251-1850
Mailing Address - Street 1:759 THE HOLLOW ROAD
Mailing Address - Street 2:
Mailing Address - City:ARARAT
Mailing Address - State:VA
Mailing Address - Zip Code:24053-3468
Mailing Address - Country:US
Mailing Address - Phone:276-251-1850
Mailing Address - Fax:
Practice Address - Street 1:1961 WILLIS GAP ROAD
Practice Address - Street 2:
Practice Address - City:ARARAT
Practice Address - State:VA
Practice Address - Zip Code:24053-3468
Practice Address - Country:US
Practice Address - Phone:276-251-1850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA772341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance