Healthcare Provider Details

I. General information

NPI: 1326220443
Provider Name (Legal Business Name): LUMBERTON RESCUE AND EMERGENCY MEDICAL SERVICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 12/06/2022
Certification Date: 12/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2391 N ROBERTS AVE
LUMBERTON NC
28358-2863
US

IV. Provider business mailing address

409 PORTER AVE
SCOTTDALE PA
15683-1141
US

V. Phone/Fax

Practice location:
  • Phone: 910-738-7275
  • Fax: 910-738-9292
Mailing address:
  • Phone: 724-887-6822
  • Fax: 724-887-9440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1189
License Number StateNC

VIII. Authorized Official

Name: MR. DANIEL COOK
Title or Position: TREASURER
Credential:
Phone: 910-739-8880