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General NPI Number Information
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NPI Number | 1275595209
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Entity Type | Organization
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Legal Business Name | BOONE TRAIL EMERGENCY SERVICES INC
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 02/10/2010
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Provider Practice Location Address
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Address Line | 7016 US 421 SOUTH
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City | LILLINGTON
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State | NC
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Zip | 27546
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Country | US
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Telephone | 910-893-3750
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 760
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City | LILLINGTON
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State | NC
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Zip | 27546-0760
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Country | US
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Telephone | 910-893-7565
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Fax | 910-893-3445
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Authorized Official
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Title or Position | RESCUE CHIEF
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Name | TONY CURRIN
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Credential |
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Telephone | 910-893-3750
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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 | 1412
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License Number State | NC
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