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General NPI Number Information
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NPI Number | 1053358994
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Entity Type | Organization
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Legal Business Name | CLAYTON RESCUE SQUAD INC
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 219 BARBOUR ST
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City | CLAYTON
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State | NC
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Zip | 27520-2403
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Country | US
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Telephone | 919-553-5493
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Fax | 919-553-3806
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Provider Business Mailing Address
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Address Line | PO BOX 45
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City | SMITHFIELD
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State | NC
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Zip | 27577-0045
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Country | US
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Telephone | 919-553-5493
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Fax | 919-553-3806
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Authorized Official
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Title or Position | CHIEF
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Name | MR. ARTHUR C MERCER JR.
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Credential |
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Telephone | 919-553-5493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number |
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License Number State | NC
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