Pamlico County Rescue Squad Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

PAMLICO COUNTY RESCUE SQUAD INC

Practice address

911 Grace Daniels Rd
Bayboro, NC 28515

Phone

(252) 745-3200

Fax

(252) 745-7883

NPI assigned

Jun 14, 2006

Last updated

Aug 22, 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

Mr. Dale R Holadia

Title

Captain

Phone

(252) 745-3200

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467495457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 302",
            "city": "BAYBORO",
            "state": "NC",
            "postal_code": "285150302",
            "telephone_number": "252-745-3200",
            "fax_number": "252-745-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 GRACE DANIELS RD",
            "city": "BAYBORO",
            "state": "NC",
            "postal_code": "28515",
            "telephone_number": "252-745-3200",
            "fax_number": "252-745-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAMLICO COUNTY RESCUE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLADIA",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CAPTAIN",
        "authorized_official_telephone_number": "252-745-3200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3406770",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Colin F Mann
• Patricia Lee Montgomery, PA-C
• Charlene McClure Morris, PAC
• George H Nashick, MD
• Pamlico County Department of Social Services
• Pamlico County Schools
• Pamlico Regional Medical Center PA
• Amber Marie Perrorazio
• Macy Poole, LCSWA
• Port Human Services

• Land Ambulance in Bayboro, NC
• Providers in Bayboro, 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 Aug 22, 2020; 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.