Active NPI
Sugar Grove Lifesaving Crew Inc
- Land Ambulance
- Sugar Grove, VA
National Provider Identifier
1972178994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- SUGAR GROVE LIFESAVING CREW INC
- Practice address
- 178 Flat Ridge Rd
Sugar Grove, VA 24375 - Phone
- (276) 677-3494
- NPI assigned
- May 21, 2021
- Last updated
- May 27, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David M Lineberry
- Title
- Captain
- Phone
- (276) 233-2682
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | NU | Primary |
Addresses
Primary practice location
178 Flat Ridge Rd
Sugar Grove, VA 24375
Mailing address
PO Box 3348
Spartanburg, SC 29304-3348
Phone (866) 764-4911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20211029002479 | VA | Part B Supplier - Ambulance Service Supplier | 1456749175 | Practice locations: Sugar Grove, VA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621555200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1653609600000",
"number": "1972178994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3348",
"city": "SPARTANBURG",
"state": "SC",
"postal_code": "293043348",
"telephone_number": "866-764-4911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "178 FLAT RIDGE RD",
"city": "SUGAR GROVE",
"state": "VA",
"postal_code": "24375",
"telephone_number": "276-677-3494"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUGAR GROVE LIFESAVING CREW INC",
"organizational_subpart": "NO",
"enumeration_date": "2021-05-21",
"last_updated": "2022-05-27",
"certification_date": "2022-05-27",
"status": "A",
"authorized_official_last_name": "LINEBERRY",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "CAPTAIN",
"authorized_official_telephone_number": "276-233-2682"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sugar Grove, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.