Provider Demographics
NPI:1063459907
Name:CLAY COUNTY
Entity Type:Organization
Organization Name:CLAY COUNTY
Other - Org Name:CLAY COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:WINGATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-389-1233
Mailing Address - Street 1:PO BOX 118
Mailing Address - Street 2:
Mailing Address - City:HAYESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28904-0118
Mailing Address - Country:US
Mailing Address - Phone:828-389-1233
Mailing Address - Fax:
Practice Address - Street 1:41 COURTHOUSE DR
Practice Address - Street 2:
Practice Address - City:HAYESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28904-4966
Practice Address - Country:US
Practice Address - Phone:828-389-1233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406831Medicaid
NC2782193Medicare ID - Type Unspecified