Healthcare Provider Details

I. General information

NPI: 1114168077
Provider Name (Legal Business Name): NORTH CAROLINA EM-1 MEDICAL SERVICES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 03/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 NORTH MAIN STREET
KENANSVILLE NC
28349
US

IV. Provider business mailing address

815 S PALAFOX ST
PENSACOLA FL
32502-5960
US

V. Phone/Fax

Practice location:
  • Phone: 910-296-0941
  • Fax: 800-305-3233
Mailing address:
  • Phone: 800-444-7009
  • Fax: 800-305-3233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: DR. TERRY R MEADOWS
Title or Position: PRESIDENT
Credential: MD
Phone: 800-444-7009