Washington County Life Saving Crew Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

WASHINGTON COUNTY LIFE SAVING CREW INC

Practice address

237 Park St SE
Abingdon, VA 24210-3311

Phone

(276) 676-2401

Fax

(276) 676-2285

NPI assigned

Oct 11, 2005

Organization subpart

No

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

Authorized official

Name

Anissa Michelle Grubb

Title

Treasurer

Phone

(276) 608-3941

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1295723658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 65",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242120065",
            "telephone_number": "276-608-3941",
            "fax_number": "276-867-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 PARK ST SE",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242103311",
            "telephone_number": "276-676-2401",
            "fax_number": "276-676-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON COUNTY LIFE SAVING CREW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-11",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "GRUBB",
        "authorized_official_first_name": "ANISSA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "276-608-3941"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1295723658",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00071239",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew Waller, MD
• Laura Marie Walts, M.A., LPC
• Lynda S Warner, L.C.S.W.
• Nathaniel Jordan Warner, CRNA
• Samantha Montgomery Warren, FNP-C
• Washington County Public Schools
• Washington County Virginia
• Randall B Wasson, DO
• Watauga Medical Group
• Watauga Orthopaedics, PLC

• Land Ambulance in Abingdon, VA
• Providers in Abingdon, VA by specialty
• Land Ambulance in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.