Provider Demographics
NPI:1760445191
Name:COUNTY OF PASQUOTANK OFFICE OF THE TREASURER
Entity Type:Organization
Organization Name:COUNTY OF PASQUOTANK OFFICE OF THE TREASURER
Other - Org Name:PASQUOTANK-CAMDEN EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PARAMEDIC
Authorized Official - Phone:252-335-1524
Mailing Address - Street 1:PO BOX 469
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27907-0469
Mailing Address - Country:US
Mailing Address - Phone:252-335-1524
Mailing Address - Fax:252-335-2560
Practice Address - Street 1:1144B N ROAD ST
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3353
Practice Address - Country:US
Practice Address - Phone:252-335-1524
Practice Address - Fax:252-335-2560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-07
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406719Medicaid
NC07240OtherBLUE CROSS FEDERAL
NC07240OtherBCBS OF NORTH CAROLINA
NC07240OtherNC TEACHER'S MAJOR MED
NC3406719Medicaid