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Organization

BLOXOM VOLUNTEER FIRE COMPANY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES BAGWELL (CHIEF)
(757) 665-4651
Entity
Organization

Contact information

Practice address
15312 BAYSIDE DR, BLOXOM, VA 23308-2820
(757) 665-5169
Mailing address
PO BOX 132, BLOXOM, VA 23308-0132
(270) 744-9600
(270) 744-8642

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
454
VA
3416L0300X
Land Ambulance
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009013601
VA
01
29304
OPTIMA
01
432960
BCBS
01
590014049
RR CARE
Enumeration date
05/24/2006
Last updated
12/07/2020
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