# GRASONVILLE VOLUNTEER AMBULANCE DEPARTMENT, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720094568
- **Authorized official:** JAMES R O'DONNELL (PRESIDENT)
- **Authorized official phone:** (410) 827-7555

## Contact information

- **Practice address:** 4132 MAIN ST, GRASONVILLE, MD 21638-1251
- **Practice address phone:** (410) 827-7555
- **Mailing address:** PO BOX 626, GRASONVILLE, MD 21638-0626
- **Mailing address phone:** (410) 827-7555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 08/01/2006
- **Last updated:** 05/22/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 279400400 | — | MD |
| 01 | — | 28916 | HEALTH AMERICA/ASSURANCE | MD |
| 01 | — | 52187279 | FEDERAL BLUE SHIELD | MD |
| 01 | — | TR46GR | CAREFIRST BLUE CROSS | MD |