Georgetown Volunteer Life Squad Association

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

GEORGETOWN VOLUNTEER LIFE SQUAD ASSOCIATION

Doing business as

Georgetown Life Squad

Practice address

821 Mt. Orab Pike
Georgetown, OH 45121

Phone

(937) 378-3082

Fax

(937) 378-4709

NPI assigned

Jul 29, 2005

Last updated

Mar 13, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Anita McKinzie

Title

EMS

Phone

(937) 378-2101

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Georgetown Life Squad Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205366400000",
    "number": "1073513206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 184",
            "city": "GEORGETOWN",
            "state": "OH",
            "postal_code": "451210184",
            "telephone_number": "937-291-7850",
            "fax_number": "937-291-2971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 MT. ORAB PIKE",
            "city": "GEORGETOWN",
            "state": "OH",
            "postal_code": "45121",
            "telephone_number": "937-378-3082",
            "fax_number": "937-378-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGETOWN VOLUNTEER LIFE SQUAD ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-29",
        "last_updated": "2008-03-13",
        "status": "A",
        "authorized_official_last_name": "MCKINZIE",
        "authorized_official_first_name": "ANITA",
        "authorized_official_title_or_position": "EMS",
        "authorized_official_telephone_number": "937-378-2101"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000006129",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0294168",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Georgetown Life Squad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Josie Ann Gast, PA-C
• Genesis Respiratory Services Inc
• Ene G George, MD
• Georgetown Emergency Group PC Inc.
• Georgetown Exempted Village School District
• Ali Ghasemzadeh, MD
• Michael Gorham, PHARMACIST
• Amy Gray
• Amanda Gregoire
• Grow Inc

• Land Ambulance in Georgetown, OH
• Providers in Georgetown, OH by specialty
• Land Ambulance in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.