Provider Demographics
NPI:1154368009
Name:COLUMBUS COUNTY EMS, INC
Entity type:Organization
Organization Name:COLUMBUS COUNTY EMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RAVEN
Authorized Official - Middle Name:STOCKS
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-770-1016
Mailing Address - Street 1:PO BOX 1124
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-1124
Mailing Address - Country:US
Mailing Address - Phone:910-640-3049
Mailing Address - Fax:910-640-2508
Practice Address - Street 1:205 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-4036
Practice Address - Country:US
Practice Address - Phone:910-640-3049
Practice Address - Fax:910-640-2508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3406747Medicaid
NC3406747Medicaid