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General NPI Number Information
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NPI Number | 1417904277
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Entity Type | Organization
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Legal Business Name | CERRO GORDO VOLUNTEER FIRE DEPARTMENT AND RESCUE SQUAD INC
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 75 E RAILROAD ST
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City | CERRO GORDO
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State | NC
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Zip | 28430-9700
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Country | US
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Telephone | 910-654-3535
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Fax | 910-654-4825
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Provider Business Mailing Address
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Address Line | 409 PORTER AVE
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City | SCOTTDALE
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State | PA
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Zip | 15683-1141
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Country | US
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Telephone | 247-887-6822
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Fax | 724-887-9440
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Authorized Official
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Title or Position | EMS COORDINATOR
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Name | MALIK WASHINGTON
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Credential |
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Telephone | 910-207-1305
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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 |
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License Number State | NC
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