Organization
HIGHLANDS AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON ALLEN SUTHERLAND (OWNER PRESIDENT)
(276) 889-5877
Entity
Organization
Contact information
Practice address
265 W.MAIN STREET, LEBANON, VA 24266-3900
(276) 889-5877
(276) 889-5799
Mailing address
PO BOX 1017, LEBANON, VA 24266
(276) 889-0600
(276) 889-4666
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
948
VA
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009012141
—
VA
01
—
252970
ANTHEM BCBS
VA
01
—
=========
UMWA
TX
Enumeration date
11/14/2006
Last updated
02/18/2020
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