=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184662090
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HARKERS ISLAND FIRE & RESCUE DEPARTMENT INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2006
-----------------------------------------------------
Last Update Date | 05/25/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1219 ISLAND ROAD
-----------------------------------------------------
City | HARKERS ISLAND
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28531-9677
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-728-4761
-----------------------------------------------------
Fax | 252-728-7988
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1308
-----------------------------------------------------
City | WALTERBORO
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29488-4509
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 843-549-3444
-----------------------------------------------------
Fax | 843-549-3474
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EMS CAPTAIN
-----------------------------------------------------
Name | DANIEL LEE SPARKS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 252-728-4761
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------