=====================================================
General NPI Number Information
=====================================================
NPI Number | 1376530725
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COUNTY OF VANCE OFFICE OF TREASURER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2005
-----------------------------------------------------
Last Update Date | 04/02/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 122 YOUNG ST SUITE B
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27536-4268
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-738-2020
-----------------------------------------------------
Fax | 252-738-2039
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 122 YOUNG ST SUITE B
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27536-4268
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-738-2020
-----------------------------------------------------
Fax | 252-738-2039
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FINANCE DIRECTOR
-----------------------------------------------------
Name | STEPHANIE WILLIAMS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 252-738-2006
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 1211
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------