Pembroke Rescue Squad

Primary specialty

AmbulanceTaxonomy code 341600000X

License

1192 Issued in NC

Legal business name

PEMBROKE RESCUE SQUAD

Practice address

210 Union Chapel Road
Pembroke, NC 28372-9620

Phone

(910) 521-2742

NPI assigned

Oct 26, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Mary T Gentile

Title

Authorized Agent

Phone

(860) 257-9201

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Pembroke Rescue Squad Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pembroke Rescue Squad, Inc.

  • Land Ambulance
  • Pembroke, NC
  • NPI 1104979368
  NPD tax ID

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386634855",
    "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": "860-257-9201",
            "fax_number": "860-721-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 UNION CHAPEL ROAD",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283729620",
            "telephone_number": "910-521-2742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEMBROKE RESCUE SQUAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GENTILE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "AUTHORIZED AGENT",
        "authorized_official_telephone_number": "860-257-9201",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NC",
            "license": "1192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406984",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pembroke Drug Center, Inc.
• Pembroke Drug Holdings, LLC
• Pembroke Drug Holdings, LLC
• Pembroke Medical Center, Inc.
• Pembroke Optometric Clinic PA
• Pembroke Rescue Squad, Inc.
• Devan Tyler Penny, ATS
• Victor Mauricio Pereira Sr., PA-C
• Joseph Perez
• Nichole Eugene Peters

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.