Provider Demographics
NPI:1184662090
Name:HARKERS ISLAND FIRE & RESCUE DEPARTMENT INC.
Entity Type:Organization
Organization Name:HARKERS ISLAND FIRE & RESCUE DEPARTMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SPARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-728-4761
Mailing Address - Street 1:PO BOX 1308
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-4509
Mailing Address - Country:US
Mailing Address - Phone:843-549-3444
Mailing Address - Fax:843-549-3474
Practice Address - Street 1:1219 ISLAND ROAD
Practice Address - Street 2:
Practice Address - City:HARKERS ISLAND
Practice Address - State:NC
Practice Address - Zip Code:28531-9677
Practice Address - Country:US
Practice Address - Phone:252-728-4761
Practice Address - Fax:252-728-7988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406802Medicaid
2783202Medicare PIN