Provider Demographics
NPI:1407964125
Name:COUNTY OF MOORE
Entity Type:Organization
Organization Name:COUNTY OF MOORE
Other - Org Name:MOORE COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:D
Authorized Official - Middle Name:BRYAN
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-947-6317
Mailing Address - Street 1:PO BOX 905
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NC
Mailing Address - Zip Code:28327-0905
Mailing Address - Country:US
Mailing Address - Phone:910-947-6317
Mailing Address - Fax:910-947-6378
Practice Address - Street 1:302 MCNEILL ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NC
Practice Address - Zip Code:28327-7589
Practice Address - Country:US
Practice Address - Phone:910-947-6317
Practice Address - Fax:910-947-6378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406998Medicaid
NC2781790Medicare PIN