MANGOHICK VOLUNTEER FIRE DEPARTMENT INC. — NPI 1457714826 (Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance in AYLETT, VA)

CMS-1500 Box 24J / 33a • NPI

1457714826

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

3416L0300X (CMS 59)

Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance

Box 32 Service Location & ZIP+4

3493 KING WILLIAM RD., AYLETT, VA, 23009

Official NPPES Practice Location

Practice Phone & Referral Fax

(804) 994-9800

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1457714826 (MANGOHICK VOLUNTEER FIRE DEPARTMENT INC.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1457714826` (NPI-2 Organization / Facility)
Provider / Legal Name	MANGOHICK VOLUNTEER FIRE DEPARTMENT INC.
Plain-English Specialty	Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance NUCC Code: `3416L0300X` (Ambulance, Land Transport)
Certifying / Licensing Body	State EMS Authority / National Registry of Emergency Medical Technicians (NREMT)
Practice Location Address	3493 KING WILLIAM RD., AYLETT, VA, 23009
Practice Telephone / Fax	Tel: (804) 994-9800
Administrative Mailing Address	PO BOX 715, MANQUIN, VA, 23106-0715
Enumeration & Last Sync	Enumerated: 2016-04-01 \| CMS Record Updated: 2018-06-20
Authorized Official	ANDREA JEWELL (EMS Captain)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

3493 KING WILLIAM RD., AYLETT, VA, 23009

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Plain-English Taxonomy & CMS Crosswalk (3416L0300X)

What Does Taxonomy Code 3416L0300X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 3416L0300X translates to:
"Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 59 (Ambulance Service Provider)
Certifying / Accrediting Authority: State EMS Authority / National Registry of Emergency Medical Technicians (NREMT)
Clinical Scope: Emergency 911 pre-hospital medical response or medically supervised inter-hospital critical care transport.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (MANGOHICK VOLUNTEER FIRE DEPARTMENT INC.)

Typical CPT / Diagnostic Procedures:

Advanced Life Support (ALS) Pre-Hospital Cardiac Monitoring & Defibrillation
Pre-Hospital Trauma Immobilization, Airway Management & IV Access

Common Therapeutic Classes:

Pre-Hospital Epinephrine, Aspirin, Nitroglycerin, Naloxone & Albuterol

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`3416L0300X` — Ambulance, Land Transport Plain English: Licensed Emergency Medical Services (EMS) — BLS/ALS Ground & Air Ambulance	State: VA \| License: `1069` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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MANGOHICK VOLUNTEER FIRE DEPARTMENT INC. (NPI #1457714826)