Provider Demographics
NPI:1124065636
Name:TOWN OF SMITHFIELD
Entity type:Organization
Organization Name:TOWN OF SMITHFIELD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:LANGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-934-7559
Mailing Address - Street 1:PO BOX 761
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-0761
Mailing Address - Country:US
Mailing Address - Phone:919-934-7559
Mailing Address - Fax:919-934-2753
Practice Address - Street 1:109 S 4TH ST
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4551
Practice Address - Country:US
Practice Address - Phone:919-934-7559
Practice Address - Fax:919-934-2753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0722XOtherBCBSNC
NC3406717Medicaid
NC=========OtherTRICARE
NC2781819Medicare ID - Type Unspecified
NC3406717Medicaid