Organization
IVA RESCUE SQUAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA J BURDETTE (CHAIRMAN OF THE BOARD OF DIRECTORS)
(864) 348-6195
Entity
Organization
Contact information
Practice address
9715 HIGHWAY 81 S, IVA, SC 29655
(864) 348-6195
(864) 348-7117
Mailing address
PO BOX 519, IVA, SC 29655
(864) 348-6195
(864) 348-7117
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
007
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AB0119
—
SC
Enumeration date
03/01/2006
Last updated
08/22/2020
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