MEDICARE: ROLESVILLE EMS, 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	341600000X	Ambulance	1397	NC
2	3416L0300X	Land Ambulance	1397	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00105643	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	07287	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1821088949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROLESVILLE EMS, INC.

Provider Business Mailing Address
First Line	:	PO BOX 863
Second Line	:
City	:	LEWISVILLE
State	:	NC
Zip	:	27023-0863
Country	:	US
Telephone Number	:	800-814-5339
Fax Number	:	336-766-1279

Provider Business Practice Location Address
First Line	:	204 E YOUNG ST
Second Line	:
City	:	ROLESVILLE
State	:	NC
Zip	:	27571-9562
Country	:	US
Telephone Number	:	919-554-3315
Fax Number	:	919-554-3350

Authorized Official
Title or Position	:	CHIEF
Name	:	TINA M COMO
Credential	:
Telephone Number	:	919-554-3315

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	09/11/2025

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Directions to “ROLESVILLE EMS, INC. ” Practice Location

Language	Start Address	Practice Location

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