Provider Demographics
NPI:1134453632
Name:ROWLAND RESCUE SQUAD INC
Entity type:Organization
Organization Name:ROWLAND RESCUE SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-733-0461
Mailing Address - Street 1:PO BOX 449
Mailing Address - Street 2:
Mailing Address - City:ROWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28383-0449
Mailing Address - Country:US
Mailing Address - Phone:910-422-3093
Mailing Address - Fax:910-422-3093
Practice Address - Street 1:302 N BOND ST
Practice Address - Street 2:
Practice Address - City:ROWLAND
Practice Address - State:NC
Practice Address - Zip Code:28383-9666
Practice Address - Country:US
Practice Address - Phone:910-422-3093
Practice Address - Fax:910-422-3093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11943416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3403808Medicaid
NC073E9OtherBLUE CROSS/BLUE SHIELD
NC073E9OtherBLUE CROSS/BLUE SHIELD