Organization
LEGACY AMBULANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY L DUNFORD EMT-INTERMEDIATE (OWNER)
(276) 971-4407
Entity
Organization
Contact information
Practice address
5453 GOVERNOR G C PEERY HWY, RAVEN, VA 24639-9533
(276) 963-5323
(276) 964-2972
Mailing address
PO BOX 580, DORAN, VA 24612-0580
(276) 963-5323
(276) 964-2972
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Enumeration date
04/13/2011
Last updated
08/24/2011
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