Provider Demographics
NPI:1639321144
Name:KLONDYKE-CHADBOURN VOLUNTEER FIRE & RESCUE INC.
Entity Type:Organization
Organization Name:KLONDYKE-CHADBOURN VOLUNTEER FIRE & RESCUE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-654-1060
Mailing Address - Street 1:PO DRAWER C
Mailing Address - Street 2:
Mailing Address - City:CHADBOURN
Mailing Address - State:NC
Mailing Address - Zip Code:28431-0000
Mailing Address - Country:US
Mailing Address - Phone:910-654-1060
Mailing Address - Fax:910-654-4903
Practice Address - Street 1:204 N. WILSON
Practice Address - Street 2:
Practice Address - City:CHADBOURN
Practice Address - State:NC
Practice Address - Zip Code:28431-0000
Practice Address - Country:US
Practice Address - Phone:910-654-1060
Practice Address - Fax:910-654-4903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14523416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport