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Organization

SANDY RIDGE RESCUE SQUAD

Active
Other names
Sandy Ridge Volunteer Rescue Squad
Organization subpart
No

Provider details

NPI number
Authorized official
MATTHEW D SLEMP (PRESIDENT/CAPTAIN)
(276) 395-3847
Entity
Organization

Contact information

Practice address
109 CARICO RDG, COEBURN, VA 24230-6418
(276) 395-3847
(276) 395-3847
Mailing address
PO BOX 550, NORA, VA 24272-0550
(276) 395-3847
(276) 395-3847

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1720409246
VA
01
618431700
FEDERAL BLACK LUNG PROGRAM
VA
Enumeration date
12/31/2013
Last updated
03/29/2016
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