Mangohick Volunteer Fire Department Inc.

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1069 Issued in VA

Legal business name

MANGOHICK VOLUNTEER FIRE DEPARTMENT INC.

Practice address

3493 King William Rd.
Aylett, VA 23009

Phone

(804) 994-9800

NPI assigned

Apr 1, 2016

Organization subpart

No

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

Authorized official

Name

Andrea S. Jewell

Title

EMS Captain

Phone

(804) 769-4381

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

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

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1457714826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 715",
            "city": "MANQUIN",
            "state": "VA",
            "postal_code": "231060715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3493 KING WILLIAM RD.",
            "city": "AYLETT",
            "state": "VA",
            "postal_code": "23009",
            "telephone_number": "804-994-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANGOHICK VOLUNTEER FIRE DEPARTMENT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-01",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "JEWELL",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "EMS CAPTAIN",
        "authorized_official_telephone_number": "804-769-4381"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "VA",
            "license": "1069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• King William Volunteer Fire and Rescue
• Augustine Warner Lewis III
• Grace Limbaugh
• Anna A Limberger, PT, PHD
• Sara Eleanor Hooper Majewski, NP
• Molly Baldwin Massey, FNP-C
• Colton Leland McGhee, ATC
• Latonia J McSwain, FNP-C
• William Mickens, QMHP
• Andrea L K Mitman

• All providers in Aylett, VA
• Land Ambulance in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.