Organization
DICKENSON COUNTY AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH DIENNE MCNUTT (PRESIDENT)
(276) 644-4987
Entity
Organization
Contact information
Practice address
142 MAIN ST, CLINTWOOD, VA 24228
(276) 926-8896
(276) 926-6915
Mailing address
PO BOX 1441, 142 MAIN ST, CLINTWOOD, VA 24228
(276) 926-8896
(276) 926-6915
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
18
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009002081
—
VA
01
—
086827500
DEPARTMENT OF LABOR
—
01
—
5524457
AETNA
—
Enumeration date
03/17/2006
Last updated
09/22/2020
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