Provider Demographics
NPI:1497156244
Name:THOMASVILLE RESCUE SQUAD
Entity Type:Organization
Organization Name:THOMASVILLE RESCUE SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:SAMMUEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:DILKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-472-7520
Mailing Address - Street 1:212 PINE ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27361-5153
Mailing Address - Country:US
Mailing Address - Phone:336-472-7520
Mailing Address - Fax:
Practice Address - Street 1:212 PINE ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-5153
Practice Address - Country:US
Practice Address - Phone:336-472-7520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1440341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance