Organization
LEBANON LIFESAVING CREW INCORPORATED
Active
Other names
Lebanon Life Saving Crew Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NOLAN STEVENS (CAPTAIN)
(276) 889-2674
Entity
Organization
Contact information
Practice address
60 SOUTH CHURCH STREET, LEBANON, VA 24266-4412
(276) 889-2674
(276) 889-4898
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-8413
(270) 744-8642
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184690372
—
VA
01
—
590015121
RAILROAD MEDICARE
VA
Enumeration date
02/27/2006
Last updated
09/24/2021
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