Organization
WASHINGTON COUNTY LIFE SAVING CREW INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANISSA MICHELLE GRUBB (TREASURER)
(276) 608-3941
Entity
Organization
Contact information
Practice address
237 PARK ST SE, ABINGDON, VA 24210-3311
(276) 676-2401
(276) 676-2285
Mailing address
PO BOX 65, ABINGDON, VA 24212-0065
(276) 608-3941
(276) 867-6622
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295723658
—
VA
01
—
P00071239
RAILROAD MEDICARE
—
Enumeration date
10/11/2005
Last updated
09/16/2021
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