Healthcare Provider Details

I. General information

NPI: 1508919069
Provider Name (Legal Business Name): COUNTY OF DUPLIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 03/14/2024
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 SEMINARY STREET
KENANSVILLE NC
28349-0000
US

IV. Provider business mailing address

PO BOX 909 209 SEMINARY STREET
KENANSVILLE NC
28349-0909
US

V. Phone/Fax

Practice location:
  • Phone: 910-296-2160
  • Fax: 910-296-2164
Mailing address:
  • Phone: 910-296-2160
  • Fax: 910-296-2164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number1079
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number0310103
License Number StateNC

VIII. Authorized Official

Name: BRANDON MCMAHON
Title or Position: DIRECTOR OF EMERGENCY SERVICES
Credential:
Phone: 910-372-9212