Pender EMS and Fire Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1578 Issued in NC

Legal business name

PENDER EMS AND FIRE INC

Practice address

805 Ridgewood Ave
Burgaw, NC 28425-5111

Phone

(910) 675-9198

Fax

(910) 675-9169

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Woodrow Wilson Sullivan III

Title

Chief

Phone

(910) 675-9166

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767657600000",
    "number": "1033205182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650",
            "city": "ROCKY POINT",
            "state": "NC",
            "postal_code": "284570650",
            "telephone_number": "910-675-9198",
            "fax_number": "910-675-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 RIDGEWOOD AVE",
            "city": "BURGAW",
            "state": "NC",
            "postal_code": "284255111",
            "telephone_number": "910-675-9198",
            "fax_number": "910-675-9169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENDER EMS AND FIRE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "WOODROW",
        "authorized_official_middle_name": "WILSON",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "910-675-9166",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NC",
            "license": "1578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "07294",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406947",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darrian Pelkey, LCSW
• Pender Adult Service, Inc
• Pender Adult Services, Inc.
• Pender County Dept of Social Services
• Pender County Schools
• Pender Memorial Hospital Inc
• Pender Memorial Hospital Inc.
• Pender Memorial Hospital Incorporated
• Pender Memorial Hospital Incorporated
• Pender Memorial Hospital, Inc

• Land Ambulance in Burgaw, NC
• Providers in Burgaw, NC by specialty
• Land Ambulance in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.