Organization
TAZEWELL COUNTY FIRE RESCUE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY T GENTILE (AUTHORIZED AGENT)
(800) 452-8191
Entity
Organization
Contact information
Practice address
725 FAIRGROUND RD, TAZEWELL, VA 24651-9790
(276) 979-9599
(276) 979-9699
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(800) 452-8191
(860) 721-6362
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
1152
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010040485
—
VA
05
—
3810013546
—
WV
01
—
P00263241
RAILROAD MEDICARE
VA
Enumeration date
10/11/2005
Last updated
12/05/2008
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