Town of Lake Waccamaw

Primary specialty

AmbulanceTaxonomy code 341600000X

Legal business name

TOWN OF LAKE WACCAMAW

Practice address

203 Flemington Dr
Lake Waccamaw, NC 28450

Phone

(910) 646-4441

NPI assigned

Mar 17, 2023

Last updated

Mar 17, 2023By 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

Mr. Douglas Sasser Jr., PARAMEDIC

Title

Captain

Phone

(910) 317-5220

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679011200000",
    "number": "1093417842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 145",
            "city": "LAKE WACCAMAW",
            "state": "NC",
            "postal_code": "284500145",
            "telephone_number": "910-646-3700"
        },
        {
            "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": "28450",
            "telephone_number": "910-646-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF LAKE WACCAMAW",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "SASSER",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "CAPTAIN",
        "authorized_official_telephone_number": "910-317-5220",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PARAMEDIC"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Living and Healthcare Center LLC (Premier Living and Rehab Center)
• Premier Living and Rehab Center
• Amy Lawson Richardson, LCSW
• Thompson Child & Family Focus
• Thompson Child & Family Focus
• Stephanie Anne Tucker, LCSWA
• Waccamaw Ultrasound & Diagnostics (Medical Center Diagnostics)
• Sarah Thomson Wyche

• Ambulance in Lake Waccamaw, NC
• Providers in Lake Waccamaw, NC by specialty
• Ambulance in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.