Provider Demographics
NPI:1538619911
Name:EASTSIDE EMS, INC
Entity type:Organization
Organization Name:EASTSIDE EMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMANDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOYNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-539-2211
Mailing Address - Street 1:308 W JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:RICH SQUARE
Mailing Address - State:NC
Mailing Address - Zip Code:27869-9549
Mailing Address - Country:US
Mailing Address - Phone:252-539-2211
Mailing Address - Fax:252-539-2212
Practice Address - Street 1:308 WEST JACKSON STREET
Practice Address - Street 2:
Practice Address - City:RICH SQUARE
Practice Address - State:NC
Practice Address - Zip Code:27869
Practice Address - Country:US
Practice Address - Phone:252-539-2211
Practice Address - Fax:252-539-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1799341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance