Organization
SOUTHSIDE VIRGINIA EMERGENCY CREW,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD BISH JR. (DIRECTOR OF OPERATIONS)
(804) 861-2739
Entity
Organization
Contact information
Practice address
425 GRAHAM RD, PETERSBURG, VA 23805-1450
(804) 861-2739
(804) 861-4184
Mailing address
PO BOX 574, PETERSBURG, VA 23804-0574
(804) 861-2739
(804) 861-4184
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
00298
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009011056
—
VA
01
—
100625
ANTHEM
—
01
—
61593
SENTARA HEALTH
—
Enumeration date
09/13/2006
Last updated
02/20/2012
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