Lake Waccamaw Fire & Rescue Squad

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1483 Issued in NC

Legal business name

LAKE WACCAMAW FIRE & RESCUE SQUAD

Practice address

203 Flemington Dr.
Lake Waccamaw, NC 28450-0000

Phone

(910) 646-4441

NPI assigned

Nov 14, 2011

Last updated

Dec 8, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles S Worrell

Title

Chief

Phone

(910) 646-1070

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1073890489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7",
            "city": "LAKE WACCAMAW",
            "state": "NC",
            "postal_code": "284500007",
            "telephone_number": "910-646-1070",
            "fax_number": "910-646-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 FLEMINGTON DR.",
            "city": "LAKE WACCAMAW",
            "state": "NC",
            "postal_code": "284500000",
            "telephone_number": "910-646-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE WACCAMAW FIRE & RESCUE SQUAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "WORRELL",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "910-646-1070"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NC",
            "license": "1483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haven Ministries, Inc.
• Teresa B Hopkins, FNP
• Journeys Healthcare
• John Paul Kretkowski
• Lake Pointe Assisted Living, Inc.
• Lake Waccamaw Primary Care, PLLC
• De'Voncia Lachel Mickins
• New Opportunities of Columbus Co.
• Danielle Nicole Poteat, LCSWA
• Premier Living and Healthcare Center LLC (Premier Living and Rehab Center)

• Land Ambulance in Lake Waccamaw, NC
• Providers in Lake Waccamaw, 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 Dec 8, 2020; 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.