Provider Demographics
NPI:1710925391
Name:UNION RESCUE SQUAD INC
Entity Type:Organization
Organization Name:UNION RESCUE SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:GIDDEONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-285-4804
Mailing Address - Street 1:PO BOX 1
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:NC
Mailing Address - Zip Code:28478-0001
Mailing Address - Country:US
Mailing Address - Phone:910-285-4804
Mailing Address - Fax:910-285-7629
Practice Address - Street 1:89 VEACH ST
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:NC
Practice Address - Zip Code:28478-7811
Practice Address - Country:US
Practice Address - Phone:910-285-4804
Practice Address - Fax:910-285-7629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406855Medicaid
NC3406855Medicaid