Organization
PRINCETON RESCUE SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STACEY HICKS (C.E.O./ADMINISTRATOR)
(304) 425-3914
Entity
Organization
Contact information
Practice address
701 STAFFORD DR, PRINCETON, WV 24740-2447
(304) 425-3914
(304) 431-3518
Mailing address
701 STAFFORD DR, PRINCETON, WV 24740-2447
(304) 425-3914
(304) 431-3518
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
12810
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0146003000
—
WV
Enumeration date
06/02/2006
Last updated
10/17/2012
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