MEDICARE: THORNE AMBULANCE SERVICE LLC

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
1	341600000X	Ambulance
2	3416L0300X	Land Ambulance	268	SC

General Provider Information

NPI Number	:	1902120397
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THORNE AMBULANCE SERVICE LLC

Provider Business Mailing Address
First Line	:	128 BATHURST LN
Second Line	:
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29681-4684
Country	:	US
Telephone Number	:	864-382-9659
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 HALTON RD STE G
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-3498
Country	:	US
Telephone Number	:	864-559-8077
Fax Number	:	864-900-0229

Authorized Official
Title or Position	:	DIRECTOR/OWNER
Name	:	RYAN THORNE
Credential	:
Telephone Number	:	864-382-9659

Provider Enumeration Date	:	03/15/2010
Last Update Date	:	01/04/2023

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