Organization
MATTAPONI VOLUNTEER RESCUE SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY MASON (CHIEF OF OPERATIONS)
(804) 937-0764
Entity
Organization
Contact information
Practice address
6089 CATEBURY ROAD, WALKERTON, VA 23177
(804) 769-3487
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-8413
(270) 744-8642
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
799
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922386846
—
KY
Enumeration date
07/26/2011
Last updated
03/17/2021
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