Healthcare Provider Details

I. General information

NPI: 1104142140
Provider Name (Legal Business Name): TOWN OF APEX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2010
Last Update Date: 04/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W. WILLIAMS STREET
APEX NC
27502-1834
US

IV. Provider business mailing address

315 W. WILLIAMS STREET
APEX NC
27502-1834
US

V. Phone/Fax

Practice location:
  • Phone: 919-363-1577
  • Fax: 919-363-1581
Mailing address:
  • Phone: 919-363-1577
  • Fax: 919-363-1581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number1212
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0727Y
Identifier TypeOTHER
Identifier StateNC
Identifier IssuerBCBS
# 2
Identifier3406974
Identifier TypeMEDICAID
Identifier StateNC
Identifier Issuer

VIII. Authorized Official

Name: MR. NIKKI WINSTEAD
Title or Position: CHIEF
Credential:
Phone: 919-363-1577