1811997745 NPI number — GILES LIFESAVING & RESCUE SQUAD, INC.

Table of content: (NPI 1811997745)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811997745 NPI number — GILES LIFESAVING & RESCUE SQUAD, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GILES LIFESAVING & RESCUE SQUAD, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811997745
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
836 4TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25701-1407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-522-7533
Provider Business Mailing Address Fax Number:
304-522-4222

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1801 WENONAH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEARISBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24134-2285
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-921-4376
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/21/2005

Additional Information

Authorized Official

Authorized Official Last Name:
CARTER
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
540-599-1301

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  218 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 590012653 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1536242 . This is a "UMWA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 281504 . This is a "BLUE CROSS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541852926 . This is a "TRICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 8002038000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9011609 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com