Provider Demographics
NPI:1356378855
Name:COUNTY OF CASWELL
Entity type:Organization
Organization Name:COUNTY OF CASWELL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-694-5177
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:208 COUNTY PARK RD
Mailing Address - City:YANCEYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27379-0099
Mailing Address - Country:US
Mailing Address - Phone:336-694-5177
Mailing Address - Fax:336-694-5738
Practice Address - Street 1:208 COUNTY PARK RD
Practice Address - Street 2:
Practice Address - City:YANCEYVILLE
Practice Address - State:NC
Practice Address - Zip Code:27379
Practice Address - Country:US
Practice Address - Phone:336-694-5177
Practice Address - Fax:336-694-5738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1361146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406848Medicaid
NC278030Medicare ID - Type UnspecifiedMEDICARE