Basic Information
| Provider Information | |||||||||
| NPI: | 1215118633 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NORTH CAROLINA EM-I MEDICAL SERVICES PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 37700 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191015000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003553818 | ||||||||
| FaxNumber: | 6108342862 | ||||||||
| Practice Location | |||||||||
| Address1: | 100 HOSPITAL DRIVE | ||||||||
| Address2: | |||||||||
| City: | LOUISBURG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9194965131 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2007 | ||||||||
| LastUpdateDate: | 02/26/2009 | ||||||||
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| AuthorizedOfficialLastName: | MEADOWS | ||||||||
| AuthorizedOfficialFirstName: | TERRY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8005078874 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine | 363A00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.