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General NPI Number Information
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NPI Number | 1023008133
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Entity Type | Organization
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Legal Business Name | EASTERN WAKE EMS INC
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Dates
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Enumeration Date | 10/28/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 401 E 3RD ST
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City | WENDELL
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State | NC
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Zip | 27591-9745
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Country | US
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Telephone | 919-365-1601
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Fax | 919-365-1602
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Provider Business Mailing Address
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Address Line | PO BOX 863
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City | LEWISVILLE
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State | NC
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Zip | 27023-0863
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Country | US
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Telephone | 800-814-5339
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Fax | 336-766-1279
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Authorized Official
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Title or Position | CHIEF
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Name | GARLAND TANT
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Credential |
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Telephone | 919-365-1601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 1215
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 1215
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License Number State | NC
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