Provider Demographics
NPI:1912229758
Name:RUTHERFORD COUNTY LIFE SAVING & FIRST AID CREW, INC
Entity Type:Organization
Organization Name:RUTHERFORD COUNTY LIFE SAVING & FIRST AID CREW, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:SOUTHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-245-5016
Mailing Address - Street 1:P.O. BOX 670
Mailing Address - Street 2:
Mailing Address - City:FOREST CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28043
Mailing Address - Country:US
Mailing Address - Phone:828-245-5016
Mailing Address - Fax:828-245-6957
Practice Address - Street 1:378 US HWY 74
Practice Address - Street 2:
Practice Address - City:BOSTIC
Practice Address - State:NC
Practice Address - Zip Code:28018
Practice Address - Country:US
Practice Address - Phone:828-245-5016
Practice Address - Fax:828-245-6957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1446341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance