Organization
SCOTT COUNTY LIFE SAVING & FIRST AID CREW INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY GENTILE (AUTHORIZED AGENT)
(800) 452-8191
Entity
Organization
Contact information
Practice address
108 PARK ST, GATE CITY, VA 24251
(276) 386-3571
(276) 386-2447
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(800) 452-8191
(860) 563-3403
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
361
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699763086
—
VA
05
—
4582509
—
TN
01
—
P00086134
RAILROAD MEDICARE
—
Enumeration date
10/10/2005
Last updated
08/07/2008
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