Provider Demographics
NPI:1902153554
Name:1ST RESPONSE AMBULANCE SERVICE
Entity Type:Organization
Organization Name:1ST RESPONSE AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:DIXON
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:434-547-9814
Mailing Address - Street 1:4600 THOMAS JEFFERSON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:CULLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23934
Mailing Address - Country:US
Mailing Address - Phone:434-547-9814
Mailing Address - Fax:
Practice Address - Street 1:4600 THOMAS JEFFERSON HIGHWAY
Practice Address - Street 2:
Practice Address - City:CULLEN
Practice Address - State:VA
Practice Address - Zip Code:23934
Practice Address - Country:US
Practice Address - Phone:434-547-9814
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-13
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport