Organization
SOUTHSIDE RESCUE SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FLOYD EDMONDS (TREASURER)
(434) 447-5038
Entity
Organization
Contact information
Practice address
810 W ATLANTIC ST, SOUTH HILL, VA 23970-1808
(434) 447-5038
Mailing address
PO BOX 660, SOUTH HILL, VA 23970-0660
(434) 447-5038
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
351129
ANTHEM
VA
05
—
4906637
—
NC
Enumeration date
09/19/2005
Last updated
10/15/2007
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