Healthcare Provider Details

I. General information

NPI: 1205590445
Provider Name (Legal Business Name): CURTIS JEROME FLUDD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: LET'S GO TRANSPORTATATION SERVICE

II. Dates (important events)

Enumeration Date: 10/25/2021
Last Update Date: 06/08/2023
Certification Date: 06/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1816 GROUND PINE DR
CHARLESTON SC
29414-8120
US

IV. Provider business mailing address

1816 GROUND PINE DR
CHARLESTON SC
29414-8120
US

V. Phone/Fax

Practice location:
  • Phone: 843-327-2011
  • Fax: 843-459-2717
Mailing address:
  • Phone: 843-327-2011
  • Fax: 843-459-2717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: