Provider Demographics
NPI:1750612248
Name:SAMARITAN AMBULANCE SERVICE, INC.
Entity type:Organization
Organization Name:SAMARITAN AMBULANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARLAND
Authorized Official - Middle Name:
Authorized Official - Last Name:TANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-365-1616
Mailing Address - Street 1:PO BOX 204
Mailing Address - Street 2:
Mailing Address - City:ZEBULON
Mailing Address - State:NC
Mailing Address - Zip Code:27597-0204
Mailing Address - Country:US
Mailing Address - Phone:919-365-2911
Mailing Address - Fax:
Practice Address - Street 1:375 E. THIRD STREET
Practice Address - Street 2:
Practice Address - City:WENDELL
Practice Address - State:NC
Practice Address - Zip Code:27591-9708
Practice Address - Country:US
Practice Address - Phone:919-365-2911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC09215703416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport