MEDICARE: NATIONAL EMERGENCY SERVICES NORTH CAROLINA INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	02779	OTHER	NC	BCBS GROUP NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063493484
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL EMERGENCY SERVICES NORTH CAROLINA INC

Provider Business Mailing Address
First Line	:	PO BOX 651062
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28265-1062
Country	:	US
Telephone Number	:	800-377-8721
Fax Number	:	304-523-2241

Provider Business Practice Location Address
First Line	:	401 N. MAIN STREET
Second Line	:	DUPLIN GENERAL HOSPITAL
City	:	KENANSVILLE
State	:	NC
Zip	:	28349
Country	:	US
Telephone Number	:	910-296-0941
Fax Number	:	910-296-2034

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	VINCENT MORRA
Credential	:
Telephone Number	:	800-377-8721

Provider Enumeration Date	:	11/11/2005
Last Update Date	:	06/20/2008

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