Healthcare Provider Details

I. General information

NPI: 1235160086
Provider Name (Legal Business Name): POCOMOKE VOL AMB CO.,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 8TH ST
POCOMOKE CITY MD
21851-1128
US

IV. Provider business mailing address

PO BOX 36
POCOMOKE CITY MD
21851-0036
US

V. Phone/Fax

Practice location:
  • Phone: 410-479-4790
  • Fax: 410-479-4793
Mailing address:
  • Phone: 410-479-4790
  • Fax: 410-479-4793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: CATHY L CARTER
Title or Position: BILLING AGENT
Credential:
Phone: 410-479-4790