Provider Demographics
NPI:1801156807
Name:POWHATAN VOLUNTEER RESCUE SQUAD, INC.
Entity type:Organization
Organization Name:POWHATAN VOLUNTEER RESCUE SQUAD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:BARTON
Authorized Official - Last Name:BEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-598-2911
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139-0247
Mailing Address - Country:US
Mailing Address - Phone:804-598-2911
Mailing Address - Fax:
Practice Address - Street 1:3920 MARION HARLAND LANE
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-7053
Practice Address - Country:US
Practice Address - Phone:804-598-2911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA001903416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport