Provider Demographics
NPI:1114193844
Name:JOHNSTON COUNTY
Entity Type:Organization
Organization Name:JOHNSTON COUNTY
Other - Org Name:JOHNSTON COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:JOHNSTON COUNTY EMERGENCY SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-989-5050
Mailing Address - Street 1:PO BOX 530
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-0000
Mailing Address - Country:US
Mailing Address - Phone:919-989-5050
Mailing Address - Fax:919-989-5052
Practice Address - Street 1:120 SOUTH THIRD STREET
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-0000
Practice Address - Country:US
Practice Address - Phone:919-989-5050
Practice Address - Fax:919-989-5052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-02
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15573416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC073EROtherBCBSNC
NC3406966Medicaid
NC3406966Medicaid