Provider Demographics
NPI:1316908080
Name:DUNN RESCUE SQUAD INC.
Entity type:Organization
Organization Name:DUNN RESCUE SQUAD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:WHITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-892-1211
Mailing Address - Street 1:PO BOX 760
Mailing Address - Street 2:
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-0760
Mailing Address - Country:US
Mailing Address - Phone:910-893-7565
Mailing Address - Fax:910-893-3445
Practice Address - Street 1:101 W CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-4813
Practice Address - Country:US
Practice Address - Phone:910-892-1211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARNETT COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-31
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11133416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0726POtherBLUE CROSS PROVIDER ID
NC3406739Medicaid
NC590013111OtherRR MEDICARE PROVIDER ID
NC590013111OtherRR MEDICARE PROVIDER ID