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Organization

POWHATAN COUNTY BOARD OF SUPERVISORS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEFFREY WALLACE (CAPTAIN)
(804) 598-5646
Entity
Organization

Contact information

Practice address
3834 OLD BUCKINGHAM RD, POWHATAN, VA 23139-7051
(804) 598-5612
Mailing address
3834 OLD BUCKINGHAM RD, POWHATAN, VA 23139-7051

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary

Other

Enumeration date
10/03/2025
Last updated
10/03/2025
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