MEDICARE: COUNTY OF WASHINGTON

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	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1790821817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF WASHINGTON

Provider Business Mailing Address
First Line	:	PO BOX 1007
Second Line	:
City	:	PLYMOUTH
State	:	NC
Zip	:	27962-1007
Country	:	US
Telephone Number	:	252-793-3523
Fax Number	:	252-793-7744

Provider Business Practice Location Address
First Line	:	958 US HIGHWAY 64 E
Second Line	:
City	:	PLYMOUTH
State	:	NC
Zip	:	27962-9216
Country	:	US
Telephone Number	:	252-793-3523
Fax Number	:	252-793-1183

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. CATHERINE W DIXON
Credential	:
Telephone Number	:	252-793-3523

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	10/09/2020

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Directions to “COUNTY OF WASHINGTON ” Practice Location

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