Organization
BEACON OF LIFE AMBULANCE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. OUIDA ANN JORDAN (CEO)
(276) 237-1767
Entity
Organization
Contact information
Practice address
16559 RIVERSIDE DR, ST. PAUL, VA 24283
(276) 237-7167
(276) 236-4725
Mailing address
109 S. MAIN ST, GALAX, VA 24333
(276) 237-7167
(276) 236-4725
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Enumeration date
10/24/2006
Last updated
07/23/2012
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