Healthcare Provider Details

I. General information

NPI: 1801895230
Provider Name (Legal Business Name): COUNTY OF PERQUIMANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 CREEK DR
HERTFORD NC
27944-9402
US

IV. Provider business mailing address

PO BOX 563
HERTFORD NC
27944-0563
US

V. Phone/Fax

Practice location:
  • Phone: 910-694-3145
  • Fax: 843-766-4994
Mailing address:
  • Phone: 252-426-5646
  • Fax: 252-426-3306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number341600000X
License Number StateNC

VIII. Authorized Official

Name: MR. JONATHAN A NIXON
Title or Position: EMS DIRECTER
Credential: EMT EMERGENCY SER.
Phone: 252-426-5646