Provider Demographics
NPI:1790766467
Name:RICHMOND RESCUE INCORPORATED
Entity Type:Organization
Organization Name:RICHMOND RESCUE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:CHIARELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-434-2394
Mailing Address - Street 1:P.O. BOX 404
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VT
Mailing Address - Zip Code:05477-0404
Mailing Address - Country:US
Mailing Address - Phone:802-434-2394
Mailing Address - Fax:802-329-2022
Practice Address - Street 1:216 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VT
Practice Address - Zip Code:05477-0404
Practice Address - Country:US
Practice Address - Phone:802-434-2394
Practice Address - Fax:802-329-2022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT059-38339RICHOtherBLUE CROSS BLUE SHIELD
VTOAM0056Medicaid
VT059-38339RICHOtherBLUE CROSS BLUE SHIELD