Conway-Severn Rescue Squad Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

1256 Issued in NC

Legal business name

CONWAY-SEVERN RESCUE SQUAD INC

Practice address

113 White Street
Conway, NC 27820

Phone

(252) 585-0026

NPI assigned

Apr 11, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Mary Gentile

Title

Authorized Agent

Phone

(800) 452-8191

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220486400000",
    "number": "1013180934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 290184",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061290184",
            "telephone_number": "800-452-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WHITE STREET",
            "city": "CONWAY",
            "state": "NC",
            "postal_code": "27820",
            "telephone_number": "252-585-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONWAY-SEVERN RESCUE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2008-09-04",
        "status": "A",
        "authorized_official_last_name": "GENTILE",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "800-452-8191",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NC",
            "license": "1256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013180934",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406979",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ambulance in Conway, NC
• Providers in Conway, NC by specialty
• Ambulance in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.