Provider Demographics
NPI:1639188162
Name:COUNTY OF CALDWELL
Entity Type:Organization
Organization Name:COUNTY OF CALDWELL
Other - Org Name:CALDWELL COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:COURTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-757-1424
Mailing Address - Street 1:PO BOX 2200
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-2200
Mailing Address - Country:US
Mailing Address - Phone:828-757-1336
Mailing Address - Fax:828-757-8696
Practice Address - Street 1:616 WEST AVE
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5188
Practice Address - Country:US
Practice Address - Phone:828-757-1336
Practice Address - Fax:828-757-8696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1041341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406637Medicaid
NC0722COtherBCBS/NC
NC0722COtherBLUE CROSS BLUE SHIELD
NC278034Medicare UPIN