Meherrin Volunteer Fire & Rescue Inc Engine Co No 5

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1017 Issued in VA

Legal business name

MEHERRIN VOLUNTEER FIRE & RESCUE INC ENGINE CO NO 5

Doing business as

Meherrin Volunteer Fire & Rescue Inc

Practice address

102 Moores Ordinary Road
Meherrin, VA 23954-0094

Phone

(434) 736-0633

NPI assigned

Apr 19, 2011

Organization subpart

No

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

Authorized official

Name

Tabitha Poore

Title

Treasurer

Phone

(434) 736-0633

Specialties & licenses 1

Addresses

Other names 1

• Meherrin Volunteer Fire & Rescue Inc Doing business as

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": "1303171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311638400000",
    "number": "1962792341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94",
            "city": "MEHERRIN",
            "state": "VA",
            "postal_code": "239540094",
            "telephone_number": "434-736-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MOORES ORDINARY ROAD",
            "city": "MEHERRIN",
            "state": "VA",
            "postal_code": "239540094",
            "telephone_number": "434-736-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEHERRIN VOLUNTEER FIRE & RESCUE INC ENGINE CO NO 5",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-19",
        "last_updated": "2011-07-26",
        "status": "A",
        "authorized_official_last_name": "POORE",
        "authorized_official_first_name": "TABITHA",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "434-736-0633"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "VA",
            "license": "1017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meherrin Volunteer Fire & Rescue Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelli Dail Baker, FNP, RN
• Tracy Childress
• Brinda Fowlkes, L.C.S.W.
• Adrieana Kirby
• Meherrin Transportation LLC
• Susan Leslie Sisler, LPC
• Brandi Trace, MA, LPC-R
• Amy Walton

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.