Healthcare Provider Details

I. General information

NPI: 1356380778
Provider Name (Legal Business Name): OTWAY VOLUNTEER FIRE DEPARTMENT INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 HWY70 OTWAY
BEAUFORT NC
28516-5154
US

IV. Provider business mailing address

509 HWY 70 E
BEAUFORT NC
28516-5154
US

V. Phone/Fax

Practice location:
  • Phone: 252-728-3150
  • Fax: 252-507-3923
Mailing address:
  • Phone: 252-728-2505
  • Fax: 843-549-3474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1359
License Number StateNC

VIII. Authorized Official

Name: PERRY MCCORMICK
Title or Position: CHIEF
Credential:
Phone: 252-342-9002