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Organization

HERBERT STEVEN PRIDGEN

Active
Other names
COASTAL AMBULANCE SERVICE
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. PATRICIA JARMAN PRIDGEN EMT I, CFO (TREASURER)
(910) 577-1846
Entity
Organization

Contact information

Practice address
705 GRANTS CREEK RD, JACKSONVILLE, NC 28546-9644
(910) 577-1846
(910) 577-3429
Mailing address
705 GRANTS CREEK RD, JACKSONVILLE, NC 28546-9644
(910) 577-1846
(910) 577-3429

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1253
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3406781
NC
Enumeration date
12/18/2006
Last updated
10/22/2007
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