Healthcare Provider Details

I. General information

NPI: 1851340202
Provider Name (Legal Business Name): TABOR CITY EMERGENCY SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 E 5TH STREET
TABOR CITY NC
28463-2203
US

IV. Provider business mailing address

409 PORTER AVE
SCOTTDALE PA
15683-1141
US

V. Phone/Fax

Practice location:
  • Phone: 910-653-2863
  • Fax: 910-377-3373
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 Number0240087
License Number StateNC

VIII. Authorized Official

Name: LORRIE LANCASTER
Title or Position: BILLING MANAGER
Credential:
Phone: 910-653-2863