Organization
MARION LIFE SAVING CREW
Active
Other names
NONE
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES CLARENCE SHUPE JR. PARAMEDIC (BILLING OFFICER)
(276) 783-4500
Entity
Organization
Contact information
Practice address
230 S PARK ST, MARION, VA 24354-2929
(276) 783-4500
(276) 783-1442
Mailing address
MARION LIFE SAVING CREW INC., PO BOX 784, MARION, VA 24354-0784
(276) 783-4500
(276) 783-1442
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
205
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000397107
BLUE CROSS BLUE SHIELD
VA
Enumeration date
01/14/2006
Last updated
08/22/2020
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