Provider Demographics
NPI:1467406116
Name:PARKWOOD VOLUNTEER FIRE DEPT INC
Entity Type:Organization
Organization Name:PARKWOOD VOLUNTEER FIRE DEPT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCCRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-361-0927
Mailing Address - Street 1:PO BOX 12224
Mailing Address - Street 2:
Mailing Address - City:RESEARCH TRIANGLE PARK
Mailing Address - State:NC
Mailing Address - Zip Code:27709-2224
Mailing Address - Country:US
Mailing Address - Phone:919-361-0927
Mailing Address - Fax:919-544-7296
Practice Address - Street 1:1409 SEATON RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-2428
Practice Address - Country:US
Practice Address - Phone:919-361-0927
Practice Address - Fax:919-544-7296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10883416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406874Medicaid
NC278092Medicare ID - Type Unspecified