Stony Creek Rescue Squad Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

304 Issued in VA

Legal business name

STONY CREEK RESCUE SQUAD INC

Practice address

13328 Bluestar Hwy
Stony Creek, VA 23882-3045

Phone

(434) 246-9300

Fax

(434) 246-9600

NPI assigned

Dec 23, 2011

Last updated

Dec 9, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Carolyn White

Title

Treasurer

Phone

(804) 712-9057

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1324598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670544000000",
    "number": "1932478773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 PORTER AVE",
            "city": "SCOTTDALE",
            "state": "PA",
            "postal_code": "156831141",
            "telephone_number": "724-887-6822",
            "fax_number": "724-887-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13328 BLUESTAR HWY",
            "city": "STONY CREEK",
            "state": "VA",
            "postal_code": "238823045",
            "telephone_number": "434-246-9300",
            "fax_number": "434-246-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONY CREEK RESCUE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-23",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-05",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "804-712-9057"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "VA",
            "license": "304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3001497562",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Personal Touch Home Care Services, Inc. (None)
• Drexel W Pierce Jr., ED.S.
• S&D First Solutions LLC
• Stony Creek Community Health Center
• Stony Creek Community Health Center (Stony Creek Pharmacy)
• Daquan Trisvan
• Howard Otto Wachsmann Jr., PHARMD

• Land Ambulance in Stony Creek, VA
• Providers in Stony Creek, VA by specialty
• Land Ambulance in Virginia

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