Organization
VERSAILLES VOLUNTEER LIFE RESCUE SQUAD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RON DEMANGE (PRESIDENT)
(937) 526-5714
Entity
Organization
Contact information
Practice address
220 W MAIN ST, VERSAILLES, OH 45380-1218
(937) 526-4899
Mailing address
548 E WOOD ST, VERSAILLES, OH 45380-1450
(937) 526-5714
(937) 526-5714
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000975
BLUECROSS/BLUESHIELD
OH
05
—
0973273
—
OH
Enumeration date
02/21/2006
Last updated
08/22/2020
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