Provider Demographics
NPI:1831146471
Name:COUNTY OF BRUNSWICK
Entity Type:Organization
Organization Name:COUNTY OF BRUNSWICK
Other - Org Name:BRUNSWICK COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS DIVISION DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HORACE
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-253-2564
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:
Mailing Address - City:BOLIVIA
Mailing Address - State:NC
Mailing Address - Zip Code:28422-0249
Mailing Address - Country:US
Mailing Address - Phone:910-253-5383
Mailing Address - Fax:910-253-4451
Practice Address - Street 1:3325 OLD OCEAN HWY
Practice Address - Street 2:
Practice Address - City:BOLIVIA
Practice Address - State:NC
Practice Address - Zip Code:28422-8919
Practice Address - Country:US
Practice Address - Phone:910-253-5383
Practice Address - Fax:910-253-4451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406644Medicaid
NC1831146471Medicaid