Pulaski County Board of Supervisors

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

PULASKI COUNTY BOARD OF SUPERVISORS

Practice address

160 Cleburne Blvd
Dublin, VA 24084-9998

Phone

(540) 633-6738

Fax

(540) 633-6745

NPI assigned

Jan 27, 2021

Organization subpart

No

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

Authorized official

Name

Mary T Gentile

Title

Authorized Official

Phone

(860) 257-7080

Specialties & licenses 1

Addresses

Other names 1

• PULASKI COUNTY PUBLIC SAFETY Doing business as

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": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644364800000",
    "number": "1689265258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290184",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061290184",
            "telephone_number": "860-257-7080",
            "fax_number": "860-563-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CLEBURNE BLVD",
            "city": "DUBLIN",
            "state": "VA",
            "postal_code": "240849998",
            "telephone_number": "540-633-6738",
            "fax_number": "540-633-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PULASKI COUNTY BOARD OF SUPERVISORS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A",
        "authorized_official_last_name": "GENTILE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "860-257-7080"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PULASKI COUNTY PUBLIC SAFETY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sean Phillips
• Audrea Carole Pratt, DDS
• Premise Health of Virginia Medical PC
• Lindsay Pugh, OT
• Pulaski Adult Day Service & Fall Prevention Center, Inc.
• Pulaski Internal Medicine, PC
• Kelly Nicole Rebkovich
• River Valley Healthcare Associates, PC
• Randall Gary Samples, MD
• Shannon Setliff

• Ambulance in Dublin, VA
• Providers in Dublin, VA by specialty
• Ambulance in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.