Provider Demographics
NPI:1306248141
Name:BOILING SPRINGS FIRE DISTRICT
Entity type:Organization
Organization Name:BOILING SPRINGS FIRE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LIEUTENANT/ MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNY
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:RABON
Authorized Official - Suffix:
Authorized Official - Credentials:NREMT PARAMEDIC
Authorized Official - Phone:864-288-5037
Mailing Address - Street 1:5020 PELHAM RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5717
Mailing Address - Country:US
Mailing Address - Phone:864-288-5037
Mailing Address - Fax:864-284-6146
Practice Address - Street 1:5020 PELHAM RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-5717
Practice Address - Country:US
Practice Address - Phone:864-288-5037
Practice Address - Fax:864-284-6146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC346146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty