Organization
GRASONVILLE VOLUNTEER AMBULANCE DEPARTMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES R O'DONNELL (PRESIDENT)
(410) 827-7555
Entity
Organization
Contact information
Practice address
4132 MAIN ST, GRASONVILLE, MD 21638-1251
(410) 827-7555
Mailing address
PO BOX 626, GRASONVILLE, MD 21638-0626
(410) 827-7555
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
279400400
—
MD
01
—
28916
HEALTH AMERICA/ASSURANCE
MD
01
—
52187279
FEDERAL BLUE SHIELD
MD
01
—
TR46GR
CAREFIRST BLUE CROSS
MD
Enumeration date
08/01/2006
Last updated
05/22/2008
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