| Organization Name: | SHADY GROVE VOLUNTEER FIRE AND RESCUE DEPARTMENT INC |
| NPI Number: | 1700886504 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DON WRAY (CHIEF) |
| Mailing Address: | 101 Shady Grove Dr Thaxton |
| State: | VA US |
| Postal Code: | 241742902 |
| Phone Number: | 5408907484 |
| Fax Number: | 5408902290 |
| NPI Enumeration Date: | 07/22/2005 |
| NPI Last Update Date: | 12/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 1002 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |