Provider Demographics
NPI:1235429531
Name:ADAMS, CHRISTOPHER (EMT-BASIC, 18D)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:EMT-BASIC, 18D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HHC, 1ST SWTG(A), D-2609, ADRENNES ST.
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310
Mailing Address - Country:US
Mailing Address - Phone:910-432-3566
Mailing Address - Fax:
Practice Address - Street 1:108 ETIENVILLE ROAD
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28307-3422
Practice Address - Country:US
Practice Address - Phone:662-316-1812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2865M2000X
NCB2009480146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic
No2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital