Healthcare Provider Details

I. General information

NPI: 1336454156
Provider Name (Legal Business Name): NORTH CAROLINA EM-I MEDICAL SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2010
Last Update Date: 08/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 FAIRVIEW RD
MOORESVILLE NC
28117-9500
US

IV. Provider business mailing address

18167 US HIGHWAY 19 N SUITE 650
CLEARWATER FL
33764-3528
US

V. Phone/Fax

Practice location:
  • Phone: 727-507-3633
  • Fax: 727-536-2896
Mailing address:
  • Phone: 800-507-8874
  • Fax: 727-536-2896

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: M.D.
Phone: 800-507-8874