Healthcare Provider Details

I. General information

NPI: 1538022165
Provider Name (Legal Business Name): LANCE HYDE PARAMEDIC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2027 PICKETT RD
SANFORD NC
27332-8591
US

IV. Provider business mailing address

2027 PICKETT RD
SANFORD NC
27332-8591
US

V. Phone/Fax

Practice location:
  • Phone: 919-356-9682
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP039539
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: