Provider Demographics
NPI:1356380778
Name:OTWAY VOLUNTEER FIRE DEPARTMENT INCORPORATED
Entity type:Organization
Organization Name:OTWAY VOLUNTEER FIRE DEPARTMENT INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-342-9002
Mailing Address - Street 1:509 HWY 70 E
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:NC
Mailing Address - Zip Code:28516-5154
Mailing Address - Country:US
Mailing Address - Phone:252-728-2505
Mailing Address - Fax:843-549-3474
Practice Address - Street 1:509 HWY70 OTWAY
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:NC
Practice Address - Zip Code:28516-5154
Practice Address - Country:US
Practice Address - Phone:252-728-3150
Practice Address - Fax:252-507-3923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13593416L0300X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406832Medicaid
NC2783137Medicare PIN