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General NPI Number Information
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NPI Number | 1568400273
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Entity Type | Organization
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Legal Business Name | IREDELL COUNTY RESCUE SQUAD INC
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 07/18/2012
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Provider Practice Location Address
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Address Line | 1902 WILKESBORO HWY
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City | STATESVILLE
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State | NC
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Zip | 28625-8737
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Country | US
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Telephone | 704-872-8192
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Fax | 704-838-0343
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Provider Business Mailing Address
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Address Line | PO BOX 781
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City | STATESVILLE
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State | NC
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Zip | 28687-0781
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Country | US
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Telephone | 704-872-8192
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Fax | 704-838-0343
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Authorized Official
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Title or Position | CHIEF/PRESIDENT
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Name | MR. DONNIE PERRY
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Credential |
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Telephone | 704-872-8192
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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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