Organization
WAVERLY RESCUE SQUAD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONITA MEYERS (TREASURER)
(407) 463-3087
Entity
Organization
Contact information
Practice address
115 BANK STREET, WAVERLY, VA 23890
(804) 834-2835
(804) 834-3116
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-8413
(270) 744-8642
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487961447
—
VA
01
—
710485000
DOL - FECA/ BL/ ENERGY
VA
Enumeration date
09/10/2010
Last updated
10/11/2021
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