Healthcare Provider Details
I. General information
NPI: 1063493484
Provider Name (Legal Business Name): NATIONAL EMERGENCY SERVICES NORTH CAROLINA INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/11/2005
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
401 N. MAIN STREET DUPLIN GENERAL HOSPITAL
KENANSVILLE NC
28349
US
IV. Provider business mailing address
PO BOX 651062
CHARLOTTE NC
28265-1062
US
V. Phone/Fax
- Phone: 910-296-0941
- Fax: 910-296-2034
- Phone: 800-377-8721
- Fax: 304-523-2241
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VINCENT
MORRA
Title or Position: PRESIDENT/CEO
Credential:
Phone: 800-377-8721