Provider Demographics
NPI:1891491627
Name:SOUTH ORANGE RESCUE SQUAD INC
Entity Type:Organization
Organization Name:SOUTH ORANGE RESCUE SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:MAUZY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-967-1515
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510-0128
Mailing Address - Country:US
Mailing Address - Phone:919-967-1515
Mailing Address - Fax:
Practice Address - Street 1:202 ROBERSON ST
Practice Address - Street 2:
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-2350
Practice Address - Country:US
Practice Address - Phone:919-967-1515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-02
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance