Provider Demographics
NPI:1871821181
Name:WISE COUNTY AMBULANCE SERVICES, LLC
Entity Type:Organization
Organization Name:WISE COUNTY AMBULANCE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:INIS
Authorized Official - Middle Name:LOIS
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-926-8896
Mailing Address - Street 1:P.O. BOX 68
Mailing Address - Street 2:
Mailing Address - City:CLINTWOOD
Mailing Address - State:VA
Mailing Address - Zip Code:24228
Mailing Address - Country:US
Mailing Address - Phone:276-926-8896
Mailing Address - Fax:276-926-4037
Practice Address - Street 1:201 VIRGINIA AVENUE, NE
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273
Practice Address - Country:US
Practice Address - Phone:276-679-3166
Practice Address - Fax:276-679-3177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport