Organization Active NPI

St Charles Volunteer Rescue Squad Inc.

  • Land Ambulance
  • St. Charles, VA
National Provider Identifier
1194992230
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
970 Issued in VA
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, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00970MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100616000591 VA Part B Supplier - Ambulance Service Supplier 0840320925 Practice locations: Saint Charles, VA

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.