Organization
BERTIE AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWARD LEE LIPSCOMB (OWNER)
(252) 794-9141
Entity
Organization
Contact information
Practice address
606 S KING ST, WINDSOR, NC 27983-1422
(252) 794-9141
(252) 794-9127
Mailing address
PO BOX 555, WINDSOR, NC 27983-0555
(252) 794-9141
(252) 794-9127
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
1463
NC
3416L0300X
Land Ambulance
Primary
1463
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0724Y
BCBS OF NC
NC
05
—
3403886
—
NC
Enumeration date
05/28/2006
Last updated
02/21/2012
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