Cordova Fire Rescue

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1617 Issued in NC

Legal business name

CORDOVA FIRE RESCUE

Practice address

108 Seventh Street
Cordova, NC 28330-8900

Phone

(910) 895-9713

NPI assigned

Apr 10, 2017

Last updated

Apr 10, 2017By 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

Jeremy Ryan Chance

Title

Deputy Chief

Phone

(910) 895-9713

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491782400000",
    "number": "1245763960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 146",
            "city": "CORDOVA",
            "state": "NC",
            "postal_code": "283300146",
            "telephone_number": "910-895-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 SEVENTH STREET",
            "city": "CORDOVA",
            "state": "NC",
            "postal_code": "283308900",
            "telephone_number": "910-895-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDOVA FIRE RESCUE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A",
        "authorized_official_last_name": "CHANCE",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "DEPUTY CHIEF",
        "authorized_official_telephone_number": "910-895-9713"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NC",
            "license": "1617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.