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Organization

HOPEWELL EMERGENCY CREW

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JERRY A WILLIAMS (TREASURER)
(804) 458-3866
Entity
Organization

Contact information

Practice address
102 S 10TH AVE, HOPEWELL, VA 23860-3839
(804) 458-3866
(804) 541-3561
Mailing address
PO BOX 659, HOPEWELL, VA 23860-0659
(804) 458-3866
(804) 458-3866

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080056400
DEPT OF LABOR AND EMPLOYMENT
VA
01
100565
BC/BS OF VIRGINIA
VA
05
1235170523
VA
01
72505
OPTIMA HEALTH
VA
01
80056400
FEDERAL BLACK LUNG PROGRAM
VA
Enumeration date
06/09/2006
Last updated
11/19/2012
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