Healthcare Provider Details

I. General information

NPI: 1962463620
Provider Name (Legal Business Name): BENHAVEN EMERGENCY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

722 BARBECUE CHURCH RD
SANFORD NC
27332-2255
US

IV. Provider business mailing address

200 N 13TH ST STE. 19A
ERWIN NC
28339-1700
US

V. Phone/Fax

Practice location:
  • Phone: 919-499-9611
  • Fax:
Mailing address:
  • Phone: 910-893-7563
  • Fax: 910-814-2570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1287
License Number StateNC

VIII. Authorized Official

Name: RICHARD SWANN
Title or Position: CHIEF
Credential:
Phone: 919-499-9611