Provider Demographics
NPI:1184679490
Name:EAST CAROLINA MEDICAL TRANSPORT, LLC
Entity Type:Organization
Organization Name:EAST CAROLINA MEDICAL TRANSPORT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:PAGE
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:MA/CAS,NCSP
Authorized Official - Phone:252-747-1117
Mailing Address - Street 1:PO BOX 617
Mailing Address - Street 2:
Mailing Address - City:SNOW HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28580-0617
Mailing Address - Country:US
Mailing Address - Phone:252-747-1117
Mailing Address - Fax:252-747-1113
Practice Address - Street 1:965 HWY 258 S
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:NC
Practice Address - Zip Code:28580-8964
Practice Address - Country:US
Practice Address - Phone:252-747-1117
Practice Address - Fax:252-747-1113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1622341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance