MEDICARE: SOUTH ROBESON RESCUE UNIT INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	1346	NC
2	3416L0300X	Land Ambulance	1346	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407844475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH ROBESON RESCUE UNIT INCORPORATED

Provider Business Mailing Address
First Line	:	409 PORTER AVE
Second Line	:
City	:	SCOTTDALE
State	:	PA
Zip	:	15683-1141
Country	:	US
Telephone Number	:	724-887-6822
Fax Number	:	724-887-9440

Provider Business Practice Location Address
First Line	:	1001 S WALNUT ST
Second Line	:
City	:	FAIRMONT
State	:	NC
Zip	:	28340-1843
Country	:	US
Telephone Number	:	910-535-8055
Fax Number	:

Authorized Official
Title or Position	:	COMMANDER
Name	:	BRANDON LEE STONE
Credential	:
Telephone Number	:	910-885-2823

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	12/06/2022

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Directions to “SOUTH ROBESON RESCUE UNIT INCORPORATED ” Practice Location

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