=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558518696
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COUNTY OF HAYWOOD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2008
-----------------------------------------------------
Last Update Date | 08/20/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 215 NORTH MAIN STREET
-----------------------------------------------------
City | WAYNESVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28786-3869
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-452-4770
-----------------------------------------------------
Fax | 828-452-6783
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1489
-----------------------------------------------------
City | CLYDE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28721-1489
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-454-0478
-----------------------------------------------------
Fax | 828-452-6783
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EMS DIRECTOR
-----------------------------------------------------
Name | MR. JIM PRESSLEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 828-452-4770
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 1367
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------