Organization
HALIFAX COUNTY RESCUE SQUAD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW J RICHARDSON JR. (PRESIDENT)
(434) 572-3960
Entity
Organization
Contact information
Practice address
700 HAMILTON BLVD, SOUTH BOSTON, VA 24592
(434) 572-3960
(434) 572-3969
Mailing address
PO BOX 183, SOUTH BOSTON, VA 24592
(434) 572-3960
(434) 572-3969
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
169
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009011773
—
VA
01
—
080055400
FED BLACK LUNG
VA
01
—
16164
OPTIMA
VA
01
—
242223
ANTHEM
VA
01
—
590011516
RR M CARE
VA
Enumeration date
05/11/2006
Last updated
04/23/2021
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