Provider Demographics
NPI:1720316615
Name:DAVIDSON COUNTY RESCUE SQUAD INC
Entity Type:Organization
Organization Name:DAVIDSON COUNTY RESCUE SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:KILGORE
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:JR
Authorized Official - Credentials:EMT
Authorized Official - Phone:336-249-0465
Mailing Address - Street 1:115 W 9TH AVE
Mailing Address - Street 2:P.O. BOX 122
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-3111
Mailing Address - Country:US
Mailing Address - Phone:336-249-9337
Mailing Address - Fax:
Practice Address - Street 1:115 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-3111
Practice Address - Country:US
Practice Address - Phone:336-249-9337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-03
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport