Provider Demographics
NPI:1932281540
Name:COUNTY OF WILSON
Entity Type:Organization
Organization Name:COUNTY OF WILSON
Other - Org Name:WILSON COUNTY EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-265-5558
Mailing Address - Street 1:P.O. BOX 429
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27023-0429
Mailing Address - Country:US
Mailing Address - Phone:800-814-5339
Mailing Address - Fax:252-977-7099
Practice Address - Street 1:1817 GLENDALE DRIVE SW
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-4401
Practice Address - Country:US
Practice Address - Phone:252-265-5558
Practice Address - Fax:252-977-7099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC590011336OtherRAIL ROAD MEDICARE
NC0726WOtherBLUE CROSS BLUE SHIELD
NC3406677Medicaid
NC590011336OtherRAIL ROAD MEDICARE