Healthcare Provider Details

I. General information

NPI: 1770530362
Provider Name (Legal Business Name): 50 & 210 EMERGENCY MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 GREENLEAF RD
ANGIER NC
27501-8732
US

IV. Provider business mailing address

52 GREENLEAF RD
ANGIER NC
27501-8732
US

V. Phone/Fax

Practice location:
  • Phone: 919-894-1565
  • Fax: 919-894-3399
Mailing address:
  • Phone: 919-894-1565
  • Fax: 919-894-3399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. RICKY G GENNINGS
Title or Position: CHIEF
Credential:
Phone: 919-894-1565