Provider Demographics
NPI:1548228380
Name:HICKORY NUT GORGE VOLUNTEER EMERGENCY MEDICAL SERVICES & RESCUE
Entity Type:Organization
Organization Name:HICKORY NUT GORGE VOLUNTEER EMERGENCY MEDICAL SERVICES & RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:F
Authorized Official - Last Name:HAMRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-625-1595
Mailing Address - Street 1:140 BILLS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LAKE LURE
Mailing Address - State:NC
Mailing Address - Zip Code:28746-9316
Mailing Address - Country:US
Mailing Address - Phone:828-652-1595
Mailing Address - Fax:
Practice Address - Street 1:140 BILLS CREEK RD
Practice Address - Street 2:
Practice Address - City:LAKE LURE
Practice Address - State:NC
Practice Address - Zip Code:28746-9316
Practice Address - Country:US
Practice Address - Phone:828-625-1595
Practice Address - Fax:828-625-0347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11993416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406865Medicaid