Provider Demographics
NPI:1245493592
Name:ANSONVILLE RESCUE & AMBULANCE
Entity type:Organization
Organization Name:ANSONVILLE RESCUE & AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-694-8548
Mailing Address - Street 1:PO BOX 444
Mailing Address - Street 2:
Mailing Address - City:ANSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28007-0000
Mailing Address - Country:US
Mailing Address - Phone:704-826-1079
Mailing Address - Fax:704-826-6370
Practice Address - Street 1:9145 US HWY 52N
Practice Address - Street 2:
Practice Address - City:ANSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28007-0000
Practice Address - Country:US
Practice Address - Phone:704-826-1079
Practice Address - Fax:704-826-6370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-08
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10073416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport