Basic Information
| Provider Information | |||||||||
| NPI: | 1295280931 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE RUGBY VOLUNTEER RESCUE SQUAD AND FIRE DEPARTMENT INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 9150 | ||||||||
| Address2: | |||||||||
| City: | PADUCAH | ||||||||
| State: | KY | ||||||||
| PostalCode: | 420029150 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2707449600 | ||||||||
| FaxNumber: | 2707448642 | ||||||||
| Practice Location | |||||||||
| Address1: | 53 RUGBY RD | ||||||||
| Address2: | |||||||||
| City: | MOUTH OF WILSON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 243633645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2765792261 | ||||||||
| FaxNumber: | 2765792261 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2016 | ||||||||
| LastUpdateDate: | 11/10/2021 | ||||||||
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| AuthorizedOfficialLastName: | ADAMS | ||||||||
| AuthorizedOfficialFirstName: | PHILLIP | ||||||||
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| AuthorizedOfficialTitleorPosition: | CAPTAIN | ||||||||
| AuthorizedOfficialTelephone: | 2765792261 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 11/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3416L0300X | 197 | VA | Y | Transportation Services | Ambulance | Land Transport |
No ID Information.