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General NPI Number Information
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NPI Number | 1952308785
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Entity Type | Organization
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Legal Business Name | LEWISTON WOODVILLE VOLUNTEER FIRE AND EMS INC.
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 103 WEST CHURCH STREET
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City | LEWISTON WOODVILLE
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State | NC
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Zip | 27849
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Country | US
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Telephone | 252-348-2658
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Fax | 252-348-2608
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Provider Business Mailing Address
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Address Line | PO BOX 431
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City | LEWISTON WOODVILLE
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State | NC
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Zip | 27849-0431
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Country | US
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Telephone | 252-348-2658
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Fax | 252-348-2608
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Authorized Official
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Title or Position | CAPTAIN
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Name | MR. JIM TAYLOR WIGGINS
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Credential |
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Telephone | 252-348-2658
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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 | 0080021
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License Number State | NC
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