BEACON OF LIFE AMBULANCE SERVICE (NPI# 1497839716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497839716 |
| Entity Type | Organization |
| Organization Name | BEACON OF LIFE AMBULANCE SERVICE |
| Practice Address |
16559 Riverside Dr St. Paul VA 24283 |
| Mailing Address |
109 S. Main St Galax VA 24333 |
| Practice Telephone | 2762377167 |
| Practice Fax Number | 2762364725 |
| Mailing Telephone | 2762377167 |
| Mailing Fax Number | 2762364725 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2012-07-23 |
| Authorized Official Name | MS. OUIDA ANN JORDAN (CEO) |
| Authorized Official Telephone | 2762371767 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
Transportation Services |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Beacon of Life Ambulance Service Inc. | 16559 Riverside Drive, P O Box 608, St Paul, Virginia 24283 |
| Street Address |
16559 RIVERSIDE DR |
| City | ST. PAUL |
| State | VA |
| Zip Code | 24283 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649510611 | Julie Large | Pharmacist | 16435 Wise St., St. Paul, VA 24283 | 2013-02-27 |
| 1144510264 | Misty D Sword Ward | Pharmacist | 16435 Wise Street, St Paul, VA 24283 | 2011-04-11 |
| 1629379292 | Family Preservation Services, Inc. | Community/Behavioral Health | 3200 Deacon Drive, Saint Paul, VA 24283 | 2010-11-12 |
| 1477736684 | Candice M Bolling | Physician Assistant | 16431 Wise St, St Paul, VA 24283 | 2007-12-11 |
| 1710104260 | St Charles Health Council Inc | Clinic/Center | 1389 Dante Road, St Paul, VA 24283 | 2007-04-19 |
| 1780712513 | James A Gross | Pharmacist | 3103 Fletcher Dr, Saint Paul, VA 24283 | 2007-03-01 |
| 1891847489 | Crystal E Burke | Social Worker | Hwy 63 North, Clinic Street, St. Paul, VA 24283 | 2007-01-17 |
| 1477571743 | Taylor D Holliday | Family Medicine | 16431 Wise St., Saint Paul, VA 24283 | 2006-07-17 |
| 1215960323 | Hamilton Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 16610 Russell Street, St Paul, VA 24283 | 2006-07-09 |
| 1114995487 | Ernie's Drug, Inc. | Pharmacist | 16408 Wise St, St. Paul, VA 24283 | 2006-03-10 |
| Find all providers in zip 24283 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.