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General NPI Number Information
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NPI Number | 1346395464
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Entity Type | Organization
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Legal Business Name | MED 1 INTER-FACILITY CARE LLC
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 220 FORLINES RD
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City | WINTERVILLE
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State | NC
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Zip | 28590-8509
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Country | US
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Telephone | 252-215-5254
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Fax | 252-215-5261
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Provider Business Mailing Address
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Address Line | PO BOX 2195 220 FORLINES RD
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City | WINTERVILLE
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State | NC
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Zip | 28590-2195
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Country | US
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Telephone | 252-215-5254
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Fax | 252-215-5261
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Authorized Official
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Title or Position | COO
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Name | MR. JOSEPH WILSON BUTLER
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Credential |
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Telephone | 252-215-5254
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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 | 1536
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License Number State | NC
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