Provider Demographics
NPI:1851671606
Name:DANVILLE LIFE SAVING AND FIRST AID CREW INC
Entity Type:Organization
Organization Name:DANVILLE LIFE SAVING AND FIRST AID CREW INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:PRUETT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:434-792-2739
Mailing Address - Street 1:202 CHRISTOPHER LN
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-2661
Mailing Address - Country:US
Mailing Address - Phone:434-792-2739
Mailing Address - Fax:434-793-3525
Practice Address - Street 1:202 CHRISTOPHER LN
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-2661
Practice Address - Country:US
Practice Address - Phone:434-792-2739
Practice Address - Fax:434-793-3525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4103416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport