Organization
PEMBROKE RESCUE SQUAD, INC.
Active
Other names
Pembroke Rescue Squad
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW LOCKLEAR (CHIEF)
(910) 521-2742
Entity
Organization
Contact information
Practice address
564 CANDY PARK RD, PEMBROKE, NC 28372-1306
(910) 521-2742
Mailing address
PO BOX 9150, PADUCAH, KY 42002-9150
(270) 744-9600
(270) 744-8642
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1192
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
073CH
BLUECROSS/BLUESHIELD NC
NC
Enumeration date
01/19/2007
Last updated
07/08/2022
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