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General NPI Number Information
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NPI Number | 1275527863
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Entity Type | Organization
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Legal Business Name | WATAUGA MEDICS INC
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 921 W KING ST
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City | BOONE
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State | NC
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Zip | 28607-3468
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Country | US
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Telephone | 828-264-9486
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Fax | 828-264-9482
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Provider Business Mailing Address
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Address Line | 921 W KING ST
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City | BOONE
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State | NC
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Zip | 28607-3468
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Country | US
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Telephone | 828-264-9486
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Fax | 828-264-9482
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Authorized Official
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Title or Position | DIRECTOR OWNER
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Name | MR. CRAIG J SULLLIVAN
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Credential |
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Telephone | 828-264-9486
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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 | 0951125
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License Number State | NC
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