Organization
CONWAY-SEVERN RESCUE SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY GENTILE (AUTHORIZED AGENT)
(800) 452-8191
Entity
Organization
Contact information
Practice address
113 WHITE STREET, CONWAY, NC 27820
(252) 585-0026
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(800) 452-8191
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
1256
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013180934
—
VA
05
—
3406979
—
NC
Enumeration date
04/11/2008
Last updated
09/04/2008
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