Provider Demographics
NPI:1245287929
Name:AMELIA EMERGENCY SQUAD INC
Entity type:Organization
Organization Name:AMELIA EMERGENCY SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAL
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-561-2339
Mailing Address - Street 1:PO BOX 888
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:VA
Mailing Address - Zip Code:23002-0888
Mailing Address - Country:US
Mailing Address - Phone:804-561-2339
Mailing Address - Fax:804-561-5897
Practice Address - Street 1:8930 OTTERBURN RD
Practice Address - Street 2:
Practice Address - City:AMELIA
Practice Address - State:VA
Practice Address - Zip Code:23002-4854
Practice Address - Country:US
Practice Address - Phone:804-561-2339
Practice Address - Fax:804-561-5897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport