Active NPI
St Charles Volunteer Rescue Squad Inc.
- Land Ambulance
- St. Charles, VA
National Provider Identifier
1194992230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 970
- Legal business name
- ST CHARLES VOLUNTEER RESCUE SQUAD INC.
- Practice address
- 2461 Saint Charles Road
Saint Charles, VA 24282-0208 - Phone
- (276) 383-4227
- NPI assigned
- May 8, 2008
- Last updated
- Jan 16, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brian Thomas Fultz, EMT-B
- Title
- Captain/Authorized Official
- Phone
- (276) 383-4017
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | NU | ||
| Land Ambulance | 3416L0300X | 970 | VA | Primary |
Addresses
Primary practice location
2461 Saint Charles Road
Saint Charles, VA 24282-0208
Mailing address
PO Box 218
Saint Charles, VA 24282-0218
Phone (276) 383-4017
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00970 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100616000591 | VA | Part B Supplier - Ambulance Service Supplier | 0840320925 | Practice locations: Saint Charles, VA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210204800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1768521600000",
"number": "1194992230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 218",
"city": "SAINT CHARLES",
"state": "VA",
"postal_code": "242820218",
"telephone_number": "276-383-4017",
"fax_number": "276-383-4447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2461 SAINT CHARLES ROAD",
"city": "SAINT CHARLES",
"state": "VA",
"postal_code": "242820208",
"telephone_number": "276-383-4227"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST CHARLES VOLUNTEER RESCUE SQUAD INC.",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-08",
"last_updated": "2026-01-16",
"certification_date": "2026-01-16",
"status": "A",
"authorized_official_last_name": "FULTZ",
"authorized_official_first_name": "BRIAN",
"authorized_official_middle_name": "THOMAS",
"authorized_official_title_or_position": "CAPTAIN/AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "276-383-4017",
"authorized_official_credential": "EMT-B"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "VA",
"license": "970",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00970",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in St. Charles, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.