Provider Demographics
NPI:1386635993
Name:ASH-RAND RESCUE SQUAD AND EMERGENCY MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:ASH-RAND RESCUE SQUAD AND EMERGENCY MEDICAL SERVICES, INC.
Other - Org Name:ASH-RAND RESCUE SQUAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:PUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-625-3354
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27204-0144
Mailing Address - Country:US
Mailing Address - Phone:336-625-3354
Mailing Address - Fax:336-625-0213
Practice Address - Street 1:805 S COX ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-6463
Practice Address - Country:US
Practice Address - Phone:336-625-3354
Practice Address - Fax:336-625-3354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406949Medicaid
NC3406949Medicaid