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NPI Code Detail

MEDICARE: ALLENDALE RESCUE SQUAD

MEDICARE: ALLENDALE RESCUE SQUAD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1341600000XAmbulance003SC

General Provider Information

NPI Number : 1154314441
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLENDALE RESCUE SQUAD
Provider Business Mailing Address
First Line : 5005 SUNSET BLVD
Second Line :
City : LEXINGTON
State : SC
Zip : 29072-9154
Country : US
Telephone Number : 803-584-4900
Fax Number :
Provider Business Practice Location Address
First Line : 5005 SUNSET BLVD
Second Line :
City : LEXINGTON
State : SC
Zip : 29072-9154
Country : US
Telephone Number : 803-957-7111
Fax Number : 803-957-7115
Authorized Official
Title or Position : EMS DIRECTOR
Name : LAWSON JOHN
Credential : NREMTP CCEMTP
Telephone Number : 803-584-4900
Provider Enumeration Date : 08/23/2005
Last Update Date : 08/22/2020

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Directions to “ALLENDALE RESCUE SQUAD ” Practice Location

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