Provider Demographics
NPI:1508803313
Name:CITY OF HAVELOCK
Entity Type:Organization
Organization Name:CITY OF HAVELOCK
Other - Org Name:HAVELOCK FIRE - RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE/RESCUE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZACCARDELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-444-6441
Mailing Address - Street 1:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:HAVELOCK
Mailing Address - State:NC
Mailing Address - Zip Code:28532-0368
Mailing Address - Country:US
Mailing Address - Phone:252-444-6441
Mailing Address - Fax:252-444-6896
Practice Address - Street 1:2 HATTERAS AVE
Practice Address - Street 2:
Practice Address - City:HAVELOCK
Practice Address - State:NC
Practice Address - Zip Code:28532-1939
Practice Address - Country:US
Practice Address - Phone:252-444-6441
Practice Address - Fax:252-444-6896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406720Medicaid
NC2783059Medicare ID - Type Unspecified
NC2783059Medicare PIN