Provider Demographics
NPI:1194992230
Name:ST CHARLES VOLUNTEER RESCUE SQUAD INC.
Entity type:Organization
Organization Name:ST CHARLES VOLUNTEER RESCUE SQUAD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:OAKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-383-4017
Mailing Address - Street 1:PO BOX 218
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:VA
Mailing Address - Zip Code:24282-0218
Mailing Address - Country:US
Mailing Address - Phone:276-383-4017
Mailing Address - Fax:276-383-4447
Practice Address - Street 1:2461 SAINT CHARLES ROAD
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:VA
Practice Address - Zip Code:24282-0208
Practice Address - Country:US
Practice Address - Phone:276-383-4227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA9703416L0300X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00970Medicaid