Organization
CHOCOWINITY EMS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE GRIER (CAPTAIN)
(252) 948-2446
Entity
Organization
Contact information
Practice address
5820 US HIGHWAY 17 S, CHOCOWINITY, NC 27817-8368
(252) 948-2446
(252) 948-0423
Mailing address
PO BOX 574, CHOCOWINITY, NC 27817-0574
(252) 948-2446
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0729Y
BLUE CROSS BLUE SHIELD
NC
01
—
2783080
MEDICARE
NC
05
—
3406886
—
NC
01
—
590014707
RAIL ROAD MEDICARE
NC
Enumeration date
10/19/2006
Last updated
12/22/2014
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