Provider Demographics
NPI:1093928814
Name:VALLEY RESCUE INC
Entity type:Organization
Organization Name:VALLEY RESCUE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLAIMS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADY
Authorized Official - Suffix:
Authorized Official - Credentials:EMT I
Authorized Official - Phone:802-496-8888
Mailing Address - Street 1:PO BOX 131
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05767-0131
Mailing Address - Country:US
Mailing Address - Phone:802-767-9200
Mailing Address - Fax:802-767-1199
Practice Address - Street 1:227 VERMONT ROUTE 100
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:VT
Practice Address - Zip Code:05748-9763
Practice Address - Country:US
Practice Address - Phone:802-767-9200
Practice Address - Fax:802-767-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTVN1151341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN1151Medicaid
028253OtherBLUE CROSS BLUE SHIELD
VTOVN1151Medicaid