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General NPI Number Information
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NPI Number | 1780936286
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Entity Type | Organization
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Legal Business Name | COUNTY OF IREDELL
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Dates
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Enumeration Date | 10/08/2012
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 2611 EBONY CIR
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City | STATESVILLE
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State | NC
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Zip | 28625-6401
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Country | US
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Telephone | 704-873-9393
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 788
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City | STATESVILLE
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State | NC
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Zip | 28687-0788
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | TRANSPORTATION DIRECTOR
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Name | BRADLEY JOHNSON
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Credential |
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Telephone | 704-880-0576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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